Hwang J-W, Jeon Y-T, Kim J-H, Oh Y-S, Park H-P
Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
Acta Anaesthesiol Scand. 2006 Sep;50(8):988-92. doi: 10.1111/j.1399-6576.2006.01050.x.
Changing the body position alters the intraocular pressure (IOP). The aim of this study was to investigate the alteration in IOP of the eyes after a positional change from a supine position to a lateral decubitus position in anesthetized patients, in order to detect differences in IOP between the two eyes, possibly due to a gravity effect, in the lateral decubitus position.
IOP was measured in 20 patients undergoing lung surgery. IOP in both eyes was recorded prior to anesthesia in the supine position (baseline), after anesthetic induction but before tracheal intubation in the supine position, at the end of central venous catheterization in the Trendelenburg position, 5 min after a positional change to the lateral decubitus position, once every 30 min until the end of surgery in the lateral decubitus position, and 5 min after changing back to the supine position.
The median IOP (16.3 mmHg; 25-75% percentile, 13-20 mmHg) in the dependent eye 5 min after changing to the lateral decubitus position increased significantly from the baseline median IOP (14.3 mmHg; 13-17.3 mmHg; P < 0.05). The increase in median IOP in the dependent eye persisted until the end of surgery in the lateral decubitus position (19 mmHg; 16.5-22.3 mmHg; P < 0.01 vs. baseline). The median IOP in the dependent eye was significantly higher than that in the non-dependent eye when anesthetized patients were placed in the lateral decubitus position (P < 0.01), and the mean differences in IOP between the eyes in the lateral decubitus position ranged from 2.9 to 4.1 mmHg.
The IOP was higher in the dependent eye than in the non-dependent eye in anesthetized patients in the lateral decubitus position, and the IOP in the dependent eye increased in anesthetized patients compared with that in awakened and supine-positioned patients.
改变体位会改变眼压（IOP）。本研究的目的是调查麻醉患者从仰卧位变为侧卧位后眼压的变化，以便检测在侧卧位时两眼之间可能由于重力作用导致的眼压差异。
对20例接受肺部手术的患者测量眼压。在仰卧位麻醉前（基线）、仰卧位麻醉诱导后但气管插管前、头低脚高位中心静脉置管结束时、变为侧卧位5分钟后、在侧卧位手术结束前每隔30分钟、以及变回仰卧位5分钟后记录两眼的眼压。
变为侧卧位5分钟后，受压眼的眼压中位数（16.3 mmHg；第25 - 75百分位数，13 - 20 mmHg）较基线眼压中位数（14.3 mmHg；13 - 17.3 mmHg）显著升高（P < 0.05）。受压眼眼压中位数的升高一直持续到侧卧位手术结束（19 mmHg；16.5 - 22.3 mmHg；与基线相比P < 0.01）。当麻醉患者处于侧卧位时，受压眼的眼压中位数显著高于非受压眼（P < 0.01），且侧卧位时两眼之间的眼压平均差异为2.9至4.1 mmHg。
在侧卧位的麻醉患者中，受压眼的眼压高于非受压眼，并且与清醒和仰卧位患者相比，麻醉患者中受压眼的眼压升高。
