Department of Anesthesiology, Nara Medical University, Kashihara, Nara, Japan.
J Neurosurg Anesthesiol. 2012 Apr;24(2):152-6. doi: 10.1097/ANA.0b013e31823fe822.
Intraocular pressure (IOP) has been shown to increase during prone spine surgery. Although propofol and sevoflurane have been widely used during such surgery, there have been no data to compare the IOP changes under propofol and sevoflurane anesthesia. The present study was therefore conducted to investigate IOP changes under propofol and sevoflurane anesthesia during prone spine surgery.
After institutional approval and informed consent, 24 patients undergoing prone spine surgery were studied. Patients were randomly allocated to 1 of 2 groups: the propofol or sevoflurane group. Propofol or sevoflurane was administered to maintain the bispectral index between 40 and 60. The IOP was measured using a Tonopen XL hand-held tonometer 10 minutes after induction of anesthesia in the supine position (baseline), 10, 60, and 120 minutes after positioning in the prone position, and 10 minutes after returning to the supine position.
There were no significant differences in IOP values at baseline between the 2 groups. IOP values after positioning in the prone position were significantly higher than those at baseline in both groups (propofol group: from 8.9±3.5 to 21.9±5.0 mm Hg; sevoflurane group: from 11.6±3.9 to 24.8±3.4 mm Hg; P<0.05). Although IOP values were higher in the sevoflurane group than in the propofol group, the differences in IOP values were not statistically significant.
The results indicated that the choice of anesthetic agent, sevoflurane or propofol, did not have significant effects on IOP changes during a relatively short interval of prone spine surgery.
已经证明,在俯卧位脊柱手术期间眼压(IOP)会升高。尽管在这种手术中广泛使用了异丙酚和七氟醚,但没有数据比较异丙酚和七氟醚麻醉下的 IOP 变化。因此,本研究旨在研究俯卧位脊柱手术中异丙酚和七氟醚麻醉下的 IOP 变化。
在获得机构批准和知情同意后,研究了 24 名接受俯卧位脊柱手术的患者。患者被随机分配到以下 2 组之一:异丙酚组或七氟醚组。异丙酚或七氟醚用于维持脑电双频指数在 40 至 60 之间。使用 Tonopen XL 手持式眼压计在麻醉诱导后 10 分钟(仰卧位时)、俯卧位后 10、60 和 120 分钟以及返回仰卧位后 10 分钟测量 IOP。
两组在基线时的 IOP 值没有显著差异。两组患者在俯卧位定位后的 IOP 值均明显高于基线值(异丙酚组:从 8.9±3.5 升至 21.9±5.0 mmHg;七氟醚组:从 11.6±3.9 升至 24.8±3.4 mmHg;P<0.05)。尽管七氟醚组的 IOP 值高于异丙酚组,但两组之间的 IOP 值差异没有统计学意义。
结果表明,在相对较短的俯卧位脊柱手术期间,麻醉剂选择异丙酚或七氟醚对 IOP 变化没有显著影响。