The Effect of Dexmedetomidine on Intraocular Pressure Increase in Patients During Robot-Assisted Laparoscopic Radical Prostatectomy in the Steep Trendelenburg Position

Kim, Na Young; Yoo, Young Chul; Park, Hee Joon; Choi, Young Deuk; Kim, Chan Yun; Bai, Sun Joon

doi:10.1089/end.2014.0381

Cited by 30 publications

(26 citation statements)

References 32 publications

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“…9,23,25,28–30 Blinding of participants and personnel was present in 11 trials, 9,19–25,28–30 6 of which accomplished blinding of outcome assessors. 19–21,28–30 No incomplete outcome data, selective reporting, or other sources of bias were found in the included studies. On the whole, 3 of all the included trials represented high-quality trials (Figure 2).…”

Section: Resultsmentioning

confidence: 99%

Effect of Dexmedetomidine in Preventing Postoperative Side Effects for Laparoscopic Surgery

et al. 2016

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Section: Resultsmentioning

confidence: 99%

Effect of Dexmedetomidine in Preventing Postoperative Side Effects for Laparoscopic Surgery

et al. 2016

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“…Dexmedetomidine reduces intraocular pressure by its central action [33]. Kim et al reported that dexmedetomidine attenuated the increases in IOP associated with steep Trendelenburg positioning during laparoscopic radical prostatectomy [34]. Reduced eye pressure may improve surgical operating conditions and decrease the risk for elevated IOP following cataract surgery [35].…”

Section: Intraocular Pressurementioning

confidence: 99%

Perioperative Dexmedetomidine for outpatient cataract surgery: a systematic review

Jones

Aldwinckle

2020

BMC Anesthesiol

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Background: Cataract surgery is one of the most common procedures performed worldwide in the elderly. Various medications can provide effective anesthesia and analgesia for cataract surgery, but undesirable side effects limit the utility of each medication or combination of medications. Dexmedetomidine may serve as an anesthesia adjunct for outpatient cataract surgery in the elderly. Methods: Searches were conducted in Cochrane, Embase, and PubMed for randomized clinical trials investigating the use of dexmedetomidine in adult patients undergoing outpatient, or ambulatory, cataract surgery with sedation and topical or peribulbar block. Ninety-nine publications were identified, of which 15 trials satisfied the inclusion criteria. A total of 914 patients were included in this review. The following data were collected: American Society of Anesthesiologists' (ASA) physical status and age of study patients; method of blinding and randomization; medication doses and routes of administration; and intraoperative levels of sedation. We also recorded statistically significant differences between dexmedetomidine and other study medications or placebo with respect to the following outcomes: hemodynamic and respiratory parameters; pain; sedation; post-operative nausea and vomiting (PONV); discharge from post-anesthesia care unit (PACU) or recovery times; patient satisfaction; surgeon satisfaction; and effects on intraocular pressure (IOP). Results: Hypotension with or without bradycardia was reported following bolus doses of dexmedetomidine ranging from 0.5-1.0 mcg/kg with or without a continuous dexmedetomidine infusion. Delayed PACU discharge times were associated with the use of dexmedetomidine, but no clear association was identified between delayed recovery and higher levels of intraoperative sedation. Better analgesia and higher patient satisfaction were commonly reported with dexmedetomidine as well as reductions in IOP. Conclusions: Overall, this review demonstrates better analgesia, higher patient satisfaction, and reduced IOP with dexmedetomidine for outpatient cataract surgery when compared to traditional sedatives, hypnotics, and opioids. These benefits of dexmedetomidine, however, must be weighed against relative cardiovascular depression and delayed PACU discharge or recovery times. Therefore, the utility of dexmedetomidine for outpatient cataract surgery should be considered on a patient-by-patient basis.

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“…Recently, several prospective clinical studies have been carried out to evaluate the effects on visual function in patients undergoing RALP . However, most studies excluded patients with pre‐existing ocular diseases, and included healthy patients who were favorable for RALP.…”

Section: Introductionmentioning

confidence: 99%

“…3,4 Recently, several prospective clinical studies have been carried out to evaluate the effects on visual function in patients undergoing RALP. [5][6][7][8][9][10][11][12][13] However, most studies excluded patients with pre-existing ocular diseases, and included healthy patients who were favorable for RALP. Thus far, there has been no prospective assessment regarding RALP for patients with ocular diseases, except for a case report; a glaucomatous patient who underwent RALP without any severe ocular damage was reported on, and how to monitor and manage elevated IOP during RALP was described.…”

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confidence: 99%

Prospective evaluation of visual function in patients with ocular diseases after robot‐assisted laparoscopic prostatectomy

et al. 2020

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Objectives To investigate intraocular pressure and visual function in patients with ocular diseases undergoing robot‐assisted laparoscopic prostatectomy. Methods We carried out a prospective clinical study of patients undergoing robot‐assisted laparoscopic prostatectomy for localized prostate cancer at The University of Tokyo Hospital from December 2015 to March 2017. An ophthalmologist measured intraocular pressure, and carried out visual field testing at 0–2 months before and 7 days after robot‐assisted laparoscopic prostatectomy. During the surgery, an anesthesiologist measured intraocular pressure at specified time points. Results A total of 110 patients were enrolled and 98 eligible patients were analyzed; 37 were diagnosed with ocular diseases before robotic‐assisted laparoscopic prostatectomy (17 with glaucoma, 20 with other ocular diseases). Intraocular pressure significantly increased during robot‐assisted laparoscopic prostatectomy. Transient postoperative visual field defect was detected in 24 eyes of 17 patients, including six patients with ocular diseases at 7 days after surgery. At 3 months after surgery, one of 34 glaucomatous eyes and one of 40 eyes with non‐glaucomatous ocular diseases continued to show visual field defect, although visual field defect in the remaining patients recovered to preoperative conditions within 3 months. Conclusions Our findings suggest that robot‐assisted laparoscopic prostatectomy can be safely carried out in patients with ocular diseases, even those with glaucoma, after precautionary consultation with an ophthalmologist.

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The Effect of Dexmedetomidine on Intraocular Pressure Increase in Patients During Robot-Assisted Laparoscopic Radical Prostatectomy in the Steep Trendelenburg Position

Abstract: Intraoperative continuous infusion of dexmedetomidine may help alleviate IOP increase in patients undergoing RALRP in the ST position.

Cited by 30 publications

References 32 publications

Effect of Dexmedetomidine in Preventing Postoperative Side Effects for Laparoscopic Surgery

Effect of Dexmedetomidine in Preventing Postoperative Side Effects for Laparoscopic Surgery

Perioperative Dexmedetomidine for outpatient cataract surgery: a systematic review

Prospective evaluation of visual function in patients with ocular diseases after robot‐assisted laparoscopic prostatectomy

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