{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T03:55:56Z","timestamp":1769831756646,"version":"3.49.0"},"reference-count":50,"publisher":"The Korean Society of Anesthesiologists","issue":"2","license":[{"start":{"date-parts":[[2022,10,24]],"date-time":"2022-10-24T00:00:00Z","timestamp":1666569600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002447","name":"Catholic University of Daegu","doi-asserted-by":"publisher","award":["201802"],"award-info":[{"award-number":["201802"]}],"id":[{"id":"10.13039\/501100002447","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["ekja.org"],"crossmark-restriction":true},"short-container-title":["Korean J Anesthesiol"],"published-print":{"date-parts":[[2023,4,1]]},"abstract":"<jats:p>Background: As a side effect of interscalene brachial plexus block (ISBPB), stellate ganglion block (SGB) causes reductions in pupil size (Horner\u2019s syndrome) and cardiac sympathetic nervous activity (CSNA). Reduced CSNA is associated with hemodynamic instability when patients are seated. Therefore, instantaneous measurements of CSNA are important in seated patients presenting with Horner\u2019s syndrome. However, there are no effective tools to measure real-time CSNA intraoperatively. To evaluate the usefulness of pupillometry in measuring CSNA, we investigated the relationship between pupil size and CSNA.Methods: Forty-two patients undergoing right arthroscopic shoulder surgery under ISBPB were analyzed. Pupil diameters were measured at 30 Hz for 2 s using a portable pupillometer. Bilateral pupil diameters and CSNA (natural-log-transformed low-frequency power [0.04\u20130.15 Hz] of heart rate variability [lnLF]) were measured before ISBPB (pre-ISBPB) and 15 min after transition to the sitting position following ISBPB (post-sitting). Changes in the pupil diameter ([right pupil diameter for post-sitting \u2013 left pupil diameter for post-sitting] \u2013 [right pupil diameter for pre-ISBPB \u2013 left pupil diameter for pre-ISBPB]) and CSNA (lnLF for post-sitting \u2013 lnLF for pre-ISBPB) were calculated.Results: Forty-one patients (97.6%) developed Horner\u2019s syndrome. Right pupil diameter and lnLF significantly decreased upon transition to sitting after ISBPB. In the linear regression model (R2 =0.242, P=0.001), a one-unit decrease (1 mm) in the extent of changes in the pupil diameter reduced the extent of changes in lnLF by 0.659 ln(ms2\/Hz) (95% CI [0.090, 1.228]).Conclusions: Pupillometry is a useful tool to measure changes in CSNA after the transition to sitting following ISBPB.<\/jats:p>","DOI":"10.4097\/kja.22324","type":"journal-article","created":{"date-parts":[[2022,10,24]],"date-time":"2022-10-24T06:18:33Z","timestamp":1666592313000},"page":"116-127","update-policy":"https:\/\/doi.org\/10.4097\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Assessment of the changes in cardiac sympathetic nervous activity using the pupil size changes measured in seated patients whose stellate ganglion is blocked by interscalene brachial plexus 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