Watcha M F, Chu F C, Stevens J L, Forestner J E
Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri.
Anesth Analg. 1990 Aug;71(2):181-4. doi: 10.1213/00000539-199008000-00011.
Intraocular pressure (IOP) measurements in children are usually performed under nitrous oxide and halothane anesthesia. We studied the effects of both time and end-tidal halothane concentration on IOP in 80 children (mean age +/- SD = 4.5 +/- 2.9 yr), to determine the most optimal time to make such measurements in anesthetized children. In 30 children the end-tidal halothane and nitrous oxide concentrations were kept constant while IOP was measured at 1-min intervals after the induction of anesthesia. Intraocular pressure did not change with time. In another 50 children IOP was measured immediately after induction, after 10 min of steady-state end-tidal halothane concentrations of both 0.5% and 1.0% in 66% nitrous oxide, and immediately after tracheal intubation. Intraocular pressure did not differ significantly at either halothane concentration but increased after tracheal intubation. We conclude that in patients anesthetized with halothane and nitrous oxide, IOP after induction remains constant over time and is not affected by end-tidal halothane concentrations up to 1.0% but is affected by tracheal intubation. Thus, the optimal time to measure IOP in children receiving up to 1% halothane in 66% nitrous oxide is during the first 10 min after induction, but before tracheal intubation.
儿童眼压(IOP)测量通常在氧化亚氮和氟烷麻醉下进行。我们研究了时间和呼气末氟烷浓度对80名儿童(平均年龄±标准差=4.5±2.9岁)眼压的影响,以确定在麻醉儿童中进行此类测量的最佳时间。在30名儿童中,呼气末氟烷和氧化亚氮浓度保持恒定,在麻醉诱导后每隔1分钟测量眼压。眼压不随时间变化。在另外50名儿童中,在诱导后、在66%氧化亚氮中呼气末氟烷浓度分别为0.5%和1.0%的稳态10分钟后以及气管插管后立即测量眼压。两种氟烷浓度下眼压均无显著差异,但气管插管后眼压升高。我们得出结论,在接受氟烷和氧化亚氮麻醉的患者中,诱导后的眼压随时间保持恒定,不受高达1.0%的呼气末氟烷浓度影响,但受气管插管影响。因此,在接受66%氧化亚氮中高达1%氟烷麻醉的儿童中,测量眼压的最佳时间是诱导后的前10分钟,但在气管插管之前。