The relationship between pupil dilation response to noxious stimulation and defense response

在人类中，瞳孔对增加的伤害性刺激作出显著的反应。然而，一个中心的悬而未决的问题是，这种瞳孔扩张反应（PDR）是否是脊髓交感神经反射或没有。我们以前的报告表明PDR可能是脑介导的反应，例如防御反应，并检查了如下两个实验：实验1：我们检查了与预期刺激（A）相比，非预期刺激（B，C，D）是否增加了PDR幅度。结果：与A相比，PDR幅度D显著增加。实验2：观察异丙酚镇静时PDR、SEP波幅是否降低（0.3，0.6，0.9 μg/ml= 0.3P，0.6P，0.9P）。0.6P、0.9P时伤害性刺激诱发的SEP波幅较对照组显著降低.在0.9P时，强刺激引起的PDR幅值较对照组显著降低. 0.9P时VAS评分较对照组明显降低.强刺激时BIS值与PDR、SEP、VAS呈正相关，说明伤害性刺激的PDR（1）随焦虑程度的增加而增大; (2)是疼痛的客观参数。(3)是镇静水平的客观参数。(4)是一种更复杂的大脑反应

The pupil dilates markedly in response to increasing noxious stimulation in humans. However, a central unresolved issue is whether this pupil dilation response (PDR) is a spinal sympathetic reflex or not. Our previous reports indicate that the PDR could be a brain-mediated response such as a defense response, and examined two experiments as follows :Experiment 1 : We examined whether PDR amplitude is increased by unexpected stimuli(B,C,D) compared to expected stimuli(A)Result : The amplitude of PDR to D significantly increased compared to that to A.Experiment 2 : We examined whether the amplitude in PDR,SEP are decreased during propofol sedation(0.3,0.6,0.9μg/ml=0.3P、0.6P、0.9P)Result :1. The amplitude of SEP to noxious stimulation during 0.6P,0.9P significantly decreased compared to that to control.2. The amplitude of PDR to strong stimulation during 0.9P significantly decreased compared to that to control.3. The VAS during 0.9P significantly decreased compared to that to control.4. BIS value were positively related to PDR,SEP and VAS with strong stimulation.We concluded that PDR to noxious stimulation(1) increases the amplitude with increasing anxiety.(2) is an objective parameter for pain.(3) is an objective parameter for sedation level.(4) is a more complex brain response.