Daneshi Ahmad, Mohebbi Saleh, Shemshadi Milad, Ghanbari Hadi
Head & Neck Research Department, Hazrat Rasoul Hospital, Iran University of Medical Sciences, Tehran, Iran.
Arch Iran Med. 2025 Jun 1;28(6):367-369. doi: 10.34172/aim.34254.
Anticholinergic agents, such as atropine and glycopyrrolate, are commonly utilized during anesthesia for their effects on secretion reduction and vagal activity. However, substantial dosages can induce mydriasis, which poses diagnostic challenges, particularly in head and neck surgeries. Despite their clinical relevance, limited studies explore these effects. A 35-year-old female presented with a left parotid mass and scheduled for a left superficial parotidectomy. Preoperatively, the patient exhibited normal ocular and neurological function. Postoperatively, fine bilateral ptosis, predominantly on the left side, and bilateral unresponsive mydriasis were noted. Anticholinergic-induced pupillary changes may mimic neurological pathology, underscoring the necessity for meticulous postoperative evaluation and awareness among clinicians.
抗胆碱能药物，如阿托品和格隆溴铵，因其减少分泌物和迷走神经活动的作用，在麻醉期间常用。然而，大剂量可诱发瞳孔散大，这带来了诊断挑战，尤其是在头颈部手术中。尽管它们具有临床相关性，但探索这些影响的研究有限。一名35岁女性因左侧腮腺肿块就诊，计划行左侧腮腺浅叶切除术。术前，患者眼部和神经功能正常。术后，发现双侧上睑轻度下垂，主要在左侧，以及双侧瞳孔散大且无反应。抗胆碱能药物引起的瞳孔变化可能会模仿神经病理学表现，这突出了临床医生进行细致术后评估和提高认识的必要性。
