Increase in intraocular pressure is less with propofol than with sevoflurane during laparoscopic surgery in the steep Trendelenburg position
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- 作者：Young-Chul Yoo MD ; PhD (1)
Seokyung Shin MD (1)
Eun Kyeong Choi MD (1)
Chan Yun Kim MD ; PhD (2)
Young Deuk Choi MD ; PhD (3)
Sun-Joon Bai MD ; PhD (1) - 刊名：Canadian Journal of Anesthesia/Journal canadien d'anesth篓娄sie
- 出版年：2014
- 出版时间：April 2014
- 年：2014
- 卷：61
- 期：4
- 页码：322-329
- 全文大小：310 KB
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33. / Lee LA, Newman NJ, Wagner TA, Dettori JR, Dettori NJ. Postoperative ischemic optic neuropathy. Spine (Phila Pa 1976) 2010; 35: S105-16 - 作者单位：Young-Chul Yoo MD, PhD (1)
Seokyung Shin MD (1)
Eun Kyeong Choi MD (1)
Chan Yun Kim MD, PhD (2)
Young Deuk Choi MD, PhD (3)
Sun-Joon Bai MD, PhD (1)
1. Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea
2. Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
3. Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea - ISSN：1496-8975
文摘
Background Intraocular pressure is increased during laparoscopic surgeries performed in a steep Trendelenburg position. This study compared the effects of propofol with those of sevoflurane on intraocular pressure in patients undergoing robot-assisted laparoscopic radical prostatectomy in a 30° Trendelenburg position. Methods Sixty-six patients were randomly allocated to a maintenance anesthetic consisting of remifentanil and sevoflurane (Sevoflurane Group) or remifentanil and propofol (Propofol Group). Intraocular pressure (IOP) was measured at nine predefined time points, including baseline (T0), five minutes after establishing pneumoperitoneum (T2), 30?min after establishing the Trendelenburg position with pneumoperitoneum (T3), five minutes after returning to the horizontal position (T4), and immediately after tracheal extubation (T6). The primary outcome was the change in intraocular pressure from T0 to T3. Results The results of linear mixed model analysis showed that intraocular pressure differed between the two groups (P?=?0.0039). At T3, the mean (SD) IOP was greater in the Sevoflurane Group [23.5 (4.3) mmHg] than in the Propofol Group [19.9 (3.8) mmHg] (P?=?0.0019). At T2 and T6, IOP was also greater in the Sevoflurane Group than in the Propofol Group (P?=?0.038 and P?=?0.009, respectively). There was a statistically significant increase in intraocular pressure from baseline to T3 (pneumoperitoneum and steep Trendelenberg) in the Sevoflurane Group [6.0 (5.0) mmHg; P?<?0.001] but not in the Propofol Group [2.1 (5.1) mmHg; P?=?0.136]. None of the patients experienced ocular complications. Conclusions Intraocular pressure increases after pneumoperitoneum and the steep Trendelenburg position are established. This increase is less with propofol than with sevoflurane anesthesia. This trial was registered at ClinicalTrials.gov: NCT01744262.