Sahin Alparslan, Tüfek Adnan, Cingü Abdullah Kürşat, Caça Ihsan, Tokgöz Orhan, Balsak Selahattin
Department of Ophthalmology, Dicle University School of Medicine, Diyarbakır, Turkey.
Paediatr Anaesth. 2012 Aug;22(8):772-5. doi: 10.1111/j.1460-9592.2012.03854.x. Epub 2012 Apr 12.
The aim of this study was to investigate the effect of I-gel(TM) laryngeal mask airway on intraocular pressure (IOP) in children with strabismus undergoing balanced anesthesia with sevoflurane or desflurane.
Forty-seven children, ASA physical status I, were scheduled for elective strabismus surgery. Patients were randomly assigned to one of the two inhalation anesthetic groups. Sevoflurane group comprised of 27 children, and desflurane group comprised of 20 children. Anesthesia was induced and maintained with sevoflurane or desflurane. No muscle relaxant was used. IOPs were measured before anesthesia, at 2 and 5 min after insertion of I-gel(TM) and after removal of I-gel(TM) . IOP measurements were obtained by Tonopen(®).
Intraocular pressure significantly decreased 2 min after insertion of I-gel(TM) in both sevoflurane and desflurane groups (P < 0.001). Measurements 5 min after I-gel(TM) insertion were also significantly lower than those of before insertion in both groups (P < 0.01). However, no significant differences were found between the preoperative measurement and the measurement after removal of I-gel(TM) within two groups (P = 0.072 and P = 0.547, respectively). No significant differences were found in all IOP measurements between sevoflurane and desflurane groups.
Insertion of I-gel(TM) laryngeal mask airway with giving sevoflurane or desflurane inhalation anesthetics seemed not to cause any increase in IOPs in pediatric ophthalmic surgery.
本研究旨在探讨I-gel™喉罩气道对斜视患儿在七氟醚或地氟醚平衡麻醉下眼内压(IOP)的影响。
47例ASA身体状况为I级的儿童计划进行择期斜视手术。患者被随机分配到两个吸入麻醉组之一。七氟醚组由27名儿童组成,地氟醚组由20名儿童组成。采用七氟醚或地氟醚诱导并维持麻醉。未使用肌肉松弛剂。在麻醉前、插入I-gel™后2分钟和5分钟以及移除I-gel™后测量眼内压。眼内压测量采用Tonopen®获得。
七氟醚组和地氟醚组在插入I-gel™后2分钟眼内压均显著降低(P<0.001)。两组在插入I-gel™后5分钟的测量值也显著低于插入前(P<0.01)。然而,两组内术前测量值与移除I-gel™后的测量值之间均未发现显著差异(分别为P = 0.072和P = 0.547)。七氟醚组和地氟醚组在所有眼内压测量值上均未发现显著差异。
在小儿眼科手术中,使用I-gel™喉罩气道并给予七氟醚或地氟醚吸入麻醉似乎不会导致眼内压升高。