Changes in intraocular pressure during surgery in the lateral decubitus position under sevoflurane and propofol anesthesia

Yamada, Makiko; Takazawa, Tomonori; Iriuchijima, Nobuhisa; Horiuchi, Tatsuo; Saito, Shigeru

doi:10.1007/s10877-015-9787-3

Cited by 16 publications

(20 citation statements)

References 19 publications

(23 reference statements)

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“…[8] A few studies have evaluated IOP changes in patients undergoing general anesthesia in a lateral decubitus position. [9,14] Hwang et al reported that IOP of the dependent eye increased about 5 mm Hg from baseline by the end of the surgery in patients undergoing lung surgery under sevoflurane anesthesia. [14] Yamada et al compared the effects of sevoflurane and propofol on IOP and documented that IOP of the dependent eye increased approximately 8 mm Hg and 3.6 mm Hg from baseline with sevoflurane and propofol anesthesia, respectively, 1 hour after the position change to lateral decubitus.…”

Section: Discussionmentioning

confidence: 99%

“…Sample size calculation was performed with a power analysis based on data from a pilot study and previous study, [9] in which the mean IOP of the dependent eye in the lateral decubitus position in the propofol anesthesia group was 19.5 mm Hg compared with 23 mm Hg in the sevoflurane group. Power estimation analysis suggested that 21 patients per group would be required to detect a mean (± SD) difference in IOP of 3.5 ± 4 mm Hg with a power of 80%, considering a type I error of 0.05.…”

Section: Methodsmentioning

confidence: 99%

“…The effects of anesthetics on IOP have been studied, and propofol is more effective than inhalation anesthetics in attenuating an IOP increase during anesthesia. [8,9] The hypothesis of this study was that propofol total intravenous anesthesia (TIVA) may be beneficial for maintaining OPP during hypotensive anesthesia because propofol may be more effective at lowering IOP.…”

Section: Introductionmentioning

confidence: 99%

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Changes of intraocular pressure and ocular perfusion pressure during controlled hypotension in patients undergoing arthroscopic shoulder surgery

2019

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Purpose: The aim of the present study is to evaluate the effects of deliberate hypotensive anesthesia on intraocular pressure (IOP) and ocular perfusion pressure (OPP) and compare the effects of propofol total intravenous anesthesia (TIVA) and desflurane anesthesia on IOP and OPP. Methods: A total of 50 patients undergoing arthroscopic shoulder surgery in the lateral decubitus position were randomized to receive desflurane or propofol anesthesia. Mean arterial pressure (MAP) was maintained in the range of 60–75 mm Hg during hypotensive anesthesia. IOP was measured using a handheld tonometer at 7 time points: before induction (T1, baseline); immediately after endotracheal intubation (T2); 10 minutes after position change to lateral decubitus (T3); 10, 30, and 50 minutes after the start of hypotensive anesthesia (T4–T6); and at the end of surgery (T7). Results: MAP decreased about 35% to 38% during hypotensive anesthesia. Compared to baseline values, the IOP at T6 in dependent and non-dependent eyes decreased by 0.43 and 2.74 mm Hg, respectively in desflurane group; 3.61 and 6.05 mm Hg, respectively in the propofol group. IOP of both eyes in the propofol group was significantly lower than in the desflurane group from T2 to T7. OPP of both eyes in both groups was significantly lower than at baseline, except at T2 in the desflurane group. OPP of both eyes in the propofol group was significantly higher than that in the desflurane group at T5 and T6. Conclusions: Hypotensive anesthesia reduced IOP and OPP, but propofol TIVA maintained higher OPP than desflurane anesthesia. These findings suggest that propofol TIVA can help mitigate the decrease of OPP during hypotensive anesthesia.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Changes of intraocular pressure and ocular perfusion pressure during controlled hypotension in patients undergoing arthroscopic shoulder surgery

2019

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“…19 Moreover, increase outflow of the aqueous humor could also contribute to the IOP decreasement. 20 Additionally, hemodynamic response associated with propofol could also reduce IOP at some degree. 7 In this study, both ipsi-operative and control-operative IOP at T2 (when TOF was below 0%) significantly decreased from the baseline values in all three groups.…”

Section: Discussionmentioning

confidence: 99%

<p>Effects of Cisatracurium, Rocuronium, and Mivacurium on Intraocular Pressure During Induction of General Anesthesia in Ophthalmic Surgery</p>

Tan

et al. 2020

DDDT

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Maintaining intraocular pressure (IOP) is important in preventing ocular complications in patients undergoing ophthalmic surgery for general anesthesia. The effects of non-depolarizing neuromuscular blockers on IOP remain unclear. The present study compared the effects of cisatracurium, rocuronium, and mivacurium on IOP during induction of general anesthesia in vitreous retinal surgery. Materials and Methods: In this prospective randomized double-blinded study, 133 patients undergoing vitreous retinal surgery were randomized into one of the three groups: Group cisatracurium (n=45), Group rocuronium (n=44), or Group mivacurium (n=44). Each drug (cisatracurium 0.1 mg kg −1 in Group cisatracurium, rocuronium 0.6 mg kg −1 in Group rocuronium, and mivacurium 0.2 mg kg −1 in Group mivacurium) was administered during induction of anesthesia. IOP and hemodynamic parameters were measured at 1 min before anesthesia induction (T0). Bispectral index (BIS) was maintained between 45 and 55 after propofol administration (T1). Train-of-four stimulation (TOF) was below 0 after muscle relaxant administration (T2) and after laryngeal mask implantation (T3). Results: Both ipsi-operative and control-operative IOP at T1, T2, and T3 significantly decreased from the baseline values (T0) in all three groups (P<0.05). The IOP changes between T1 and T2 among three groups were similar (P>0.05). The values of systolic blood pressure (SBP) and diastolic blood pressure (DBP) at T1 and T2 significantly decreased in all three groups compared to T0 (P<0.05). Conclusion: Bilateral IOP significantly decreased from the baseline values in all three groups during the induction phase. Cisatracurium, rocuronium, and mivacurium did not induce significant changes in bilateral IOP.

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“…Besides, the effect of inhalational sevoflurane anesthesia on lowering the intraocular pressure is already well known. 24,25 Data analysis was performed using the Statistical Package for Social Sciences SPSS for Windows version 20.0 (SPSS Inc., Chicago, IL, USA). Quantitative data were described using range, mean and standard deviation.…”

Section: Trabeculectomy Techniquementioning

confidence: 99%

<p>Non-Penetrating Deep Sclerectomy versus Trabeculectomy in Primary Congenital Glaucoma</p>

Elhofi¹,

Helaly²

2020

OPTH

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Purpose: To evaluate the safety and efficacy of non-penetrating deep sclerectomy with a collagen implant versus trabeculectomy in primary congenital glaucoma. Subjects and Methods: This was a retrospective interventional comparative nonrandomized clinical study that included 80 eyes of 80 children presenting with primary congenital glaucoma under the age of 3 years. Forty eyes have undergone non-penetrating deep sclerectomy (NPDS) and the other 40 eyes have undergone penetrating trabeculectomy. The main outcome measure was the reduction in intraocular pressure (IOP). Secondary outcomes included percentage of patients with complete and qualified success, need for topical antiglaucoma medications, rate of complications, and need for further interventions. Complete success of the surgical outcome was considered an IOP ≤16 mmHg with no antiglaucoma medications. Qualified success was considered an IOP ≤16 mmHg using antiglaucoma medications. Results: The mean preoperative IOP was 27.4 ± 6.9 and 28.5 ± 6.6 mmHg in NPDS and trabeculectomy groups, respectively (p = 0.175). At the end of the follow-up period, the mean IOP was 11.2 ± 4.5 and 11.1 ± 3.4 mmHg with a mean reduction of 16.2 and 17.4 mmHg in NPDS and trabeculectomy groups, respectively. At the end of the follow-up period, ie at 36 months postoperative, the complete success rate was 60% (24 eyes) versus 57.5% (23 eyes), the qualified success rate was 25% (10 eyes) versus 25% (10 eyes), the overall success rate was 85% (34 eyes) versus 82.5% (33 eyes), and the rate of failure was 15% (6 eyes) versus 17.5% (7 eyes) in NPDS and trabeculectomy groups, respectively (p = 0.952). Eight cases (20%) of the trabeculectomy group had shallow anterior chamber. None of the NPDS group cases suffered from shallow anterior chamber. Conclusion: Non-penetrating deep sclerectomy appears to be an efficient and safe surgical alternative to penetrating trabeculectomy in treatment of primary congenital glaucoma. Nonpenetrating deep sclerectomy has fewer postoperative complications in comparison to penetrating trabeculectomy with a comparative postoperative reduction in the intraocular pressure and overall success rates. Trial Registration: The trial was registered on 11/01/2020 with number PACTR202002874953456 (https://pactr.samrc.ac.za).

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Changes in intraocular pressure during surgery in the lateral decubitus position under sevoflurane and propofol anesthesia

Cited by 16 publications

References 19 publications

Changes of intraocular pressure and ocular perfusion pressure during controlled hypotension in patients undergoing arthroscopic shoulder surgery

Changes of intraocular pressure and ocular perfusion pressure during controlled hypotension in patients undergoing arthroscopic shoulder surgery

<p>Effects of Cisatracurium, Rocuronium, and Mivacurium on Intraocular Pressure During Induction of General Anesthesia in Ophthalmic Surgery</p>

<p>Non-Penetrating Deep Sclerectomy versus Trabeculectomy in Primary Congenital Glaucoma</p>

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