A Case Report of Mydriasis and Cycloplegia Developing after General Anesthesia / 대한마취과학회지

ABSTRACT

Belladonna drugs dilate the pupil and paralyze accomodation after either local or systemic administration. Conventional systemic doses of atropine (0.5-0.6 mg) have little ocular effect, but with larger doses ocular effects develop. We experienced one case where a 30 year old healthy male patient developed mydriasis and cycloplegia of unknown origin on both eyes after general anesthesia for removal of intracerebral hematoma of left superficial parietal area. The symptoms disappeared spontaneously 11 days after the operation without any treatment. During the operation, the vital signs were stable, there was no sign of increased intracerebral pressure or rebleeding, and there was no abnormal ophthalmic findings. We could not find any definite causes of mydriasis and cycloplegia in this case, except that the patient received large doses of belladonna drugs during the anesthesia, such as Robinul 0.2 mg IM as premedicant, atropine 0.5 mg IV for treatment of bradycardia, and Robinul 0.2 mg IV for reversal of muscle relaxation with neostigmine 1.0 mg. Careful examination of all the circumstances would not let us exclude the possibility that the cause was atropine and robinul.