{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,4,4]],"date-time":"2022-04-04T22:44:00Z","timestamp":1649112240521},"reference-count":4,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2017,1,23]],"date-time":"2017-01-23T00:00:00Z","timestamp":1485129600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Laryngol. Otol."],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0022215117000068_sec_a1\"><jats:title>Objectives:<\/jats:title><jats:p>When performing septoplasty or septorhinoplasty, we have observed that patients blink on injection of local anaesthetic (lidocaine 1 per cent with adrenaline 1:80 000) into the nasal mucosa of the anterior septum or vestibular skin, despite appropriate general anaesthesia. This study sought to quantify this phenomenon by conducting a prospective audit of all patients undergoing septoplasty or septorhinoplasty.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215117000068_sec_a2\"><jats:title>Methods:<\/jats:title><jats:p>Patients were observed for a blink reflex at the time of local anaesthetic infiltration into the nasal vestibule. Also measured at this point were propofol target-controlled infusion levels, remifentanil rate, bispectral index, blood pressure, heart rate, pupil size and position, and patient movement.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215117000068_sec_a3\"><jats:title>Results:<\/jats:title><jats:p>There were 15 blink reflexes in the 30 patients observed. The average bispectral index value was 32.75 (range, 22\u201350) in the blink group and 26.77 (range, 18\u201349) in the non-blink group. No patients moved on local anaesthetic injection.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215117000068_sec_a4\"><jats:title>Conclusion:<\/jats:title><jats:p>The blink reflex appears to occur in 50 per cent of patients, despite a deep level of anaesthesia. Without an understanding and appreciation of the blink reflex, this event may result in a request to deepen anaesthesia, but this is not necessary and surgery can proceed safely.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0022215117000068","type":"journal-article","created":{"date-parts":[[2017,1,23]],"date-time":"2017-01-23T05:35:50Z","timestamp":1485149750000},"page":"347-349","source":"Crossref","is-referenced-by-count":0,"title":["The Doyle\u2013Saleh blink reflex"],"prefix":"10.1017","volume":"131","author":[{"given":"P W","family":"Doyle","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I","family":"Beegun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H A","family":"Saleh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2017,1,23]]},"reference":[{"key":"S0022215117000068_ref4","doi-asserted-by":"publisher","DOI":"10.1159\/000324459"},{"key":"S0022215117000068_ref1","unstructured":"Corneal reflex. In: http:\/\/en.wikipedia.org\/wiki\/Corneal_reflex [30 July 2014]"},{"key":"S0022215117000068_ref2","unstructured":"Nasal Anatomy. In: http:\/\/emedicine.medscape.com\/article\/835134-overview [30 July 2014]"},{"key":"S0022215117000068_ref3","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000155287.54904.EB"}],"container-title":["The Journal of Laryngology &amp; Otology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0022215117000068","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,4,17]],"date-time":"2019-04-17T21:42:03Z","timestamp":1555537323000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0022215117000068\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,1,23]]},"references-count":4,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2017,4]]}},"alternative-id":["S0022215117000068"],"URL":"https:\/\/doi.org\/10.1017\/s0022215117000068","relation":{},"ISSN":["0022-2151","1748-5460"],"issn-type":[{"value":"0022-2151","type":"print"},{"value":"1748-5460","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,1,23]]}}}