Perioperative Follow-up assessment of vegetative state neurosurgery patients using Ashner’s reflex and Kerdo’s index

Abstract

This work is devoted to the study of the state of the autonomic nervous system in the perioperative period in neurosurgical patients by assessing the Ashner reflex and the Kerdo index.

OBJECTIVE: to study the dynamics of the Ashner reflex and the Kerdo index in neurosurgical patients under general anesthesia.

MATERIALS AND METHODS: The study included 45 patients who underwent a planned neurosurgical operation under general anesthesia, the patients were divided into three groups. The Ashner reflex and the Kerdo index were evaluated at six stages of the operation, and based on the data obtained, conclusions were drawn about the state of the autonomic nervous system.

RESULTS: All patients of the first group at the main stage of the operation showed signs of sympathicotonia, patients of the second group were divided between eutonia and sympathicotonia, patients of the third group were dominated by sympathicotonia. At the end of the operation, after awakening, the Ashner reflex was evoked, which was regarded as eutonia.

CONCLUSION: Under general anesthesia, it is possible to assess the state of the autonomic nervous system based on the preservation of the Ashner reflex. Depending on the method of anesthesia used, this indicator of autonomic nervous system reactivity is preserved to a greater or lesser extent.