Autonomic Reflexes

The autonomic nervous system is divided into the parasympathetic and sympathetic nervous system. The autonomic nervous system targets smooth muscle to exert its effect on heart rate, respiratory rate, gastrointestinal function, urination, and gland activity. Autonomic reflexes are involuntary and are a result of an autonomic reflex arc which consists of a receptor, sensory neuron, integrating center, and both a preganglionic and postganglionic motor neuron. Disease states that disrupt the autonomic nervous system have several anesthetic implications to consider. Preoperative bowel care and voiding prior to surgery reduces the risk of bladder or bowel distension intraoperatively. Aggressive blood pressure management intraoperatively and removing the noxious stimuli is recommended.