Changes in intraocular pressure during surgery in the lateral decubitus position under sevoflurane and propofol anesthesia.
Changes in intraocular pressure during surgery in the lateral decubitus position under sevoflurane and propofol anesthesia.
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DOI：
10.1007/s10877-015-9787-3
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发表时间：
2016-12
影响因子：
2.2
通讯作者：
Saito, Shigeru
中科院分区：
文献类型：
--
作者：
Yamada, Makiko Hardy;Takazawa, Tomonori;Iriuchijima, Nobuhisa;Horiuchi, Tatsuo;Saito, Shigeru
眼压（IOP）已被证明会随着身体位置的变化而变化。多项研究表明，侧卧位 (LDP) 与依赖眼的 IOP 显着增加相关。然而，麻醉剂是否会改变 LDP 的眼压仍不清楚。本研究调查了七氟醚和丙泊酚麻醉对 LDP 眼压的影响。总共包括 28 名在 LDP 接受手术的患者。患者被随机分配到七氟醚组或丙泊酚组。在五个时间点记录并比较两组眼睛的眼压：麻醉诱导后、气管插管后、改变 LDP 位置后 5 分钟和 1 小时、以及返回仰卧位后 5 分钟。在七氟醚组中，改用 LDP 1 小时后，依赖眼和非依赖眼的 IOP 均显着增加。在异丙酚组中，气管插管后，依赖眼和非依赖眼的眼压均下降，但改为LDP后眼压没有增加。七氟醚组眼压升高至 ≥28 mmHg 的患者数量多于丙泊酚组。对于 LDP 的麻醉维持，异丙酚可能比七氟醚更好。 LDP 中眼压的监测可能有助于避免眼科并发症。
Intraocular pressure (IOP) has been shown to change with body position. Several studies have shown that the lateral decubitus position (LDP) is associated with a significant increase in IOP in the dependent eye. However, whether anesthetic agents alter IOP in the LDP remains unclear. This study investigated the effect of sevoflurane and propofol anesthesia on IOP in the LDP. A total of 28 patients undergoing surgery in the LDP were included. Patients were randomly allocated to sevoflurane or propofol groups. IOP in both eyes was recorded and compared between groups at five time points: after anesthesia induction, after endotracheal intubation, at 5 min and 1 h after a positional change to the LDP, and 5 min after returning to the supine position. In the sevoflurane group, IOP was significantly increased in both dependent and non-dependent eyes 1 h after changing to the LDP. In the propofol group, IOP decreased in both dependent and non-dependent eyes after tracheal intubation, but did not increase after changing to the LDP. The number of patients in whom IOP increased to ≥28 mmHg was greater in the sevoflurane group than in the propofol group. Propofol may be better than sevoflurane for the maintenance of anesthesia in the LDP. Monitoring of IOP in the LDP might help avoid ophthalmic complications.
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