Deniz M Nuri, Erakgün Arzum, Sertöz Nezih, Yilmaz Suzan Güven, Ateş Halil, Erhan Elvan
MD; Ege University School of Medicine Department of Anesthesiology and Reanimation.
MD; Ege University School of Medicine Department of Anesthesiology and Reanimation.
Braz J Anesthesiol. 2013 Mar-Apr;63(2):209-12. doi: 10.1016/j.bjane.2012.03.008. Epub 2013 Aug 13.
The increased intraocular pressure (IOP) - which decreases perfusion pressure on the optic nerve - increases by prone positioning (1). The aim of our study was to compare the effect of head rotation 45° laterally in prone position on the increase in IOP of upper placed and lower placed eyes in patients undergoing percutaneous nephrolithotomy (PCNL).
Forty-five patients were randomly divided into 2 Groups. IOP of the patients were recorded bilaterally in supine position before the operation had started. Patients were turned to prone position. The head was placed on a prone headrest without external direct compression to both eyes. Patients in Group I were kept in strictly neutral prone position where as patients in Group II were placed prone with their heads rotated 45° laterally to the right side. At the end of the operation, patients were turned to supine position and their IOP was measured immediately.
There was no difference related to demographics, duration of surgery, blood loss and fluid input data. IOP values after surgery in prone position increased significantly compared to preoperative values in both groups (p < 0.05). After surgery in prone position IOP values of the upper positioned eyes in Group II were significantly lower than Group I and lower positioned eyes in Group II (p < 0.05).
prone positioning increases IOP. In patients with prone position with a head rotation of 45° laterally, IOP in the upper positioned eye was significantly lower.
俯卧位会使眼内压（IOP）升高，而眼内压升高会降低视神经的灌注压（1）。本研究的目的是比较经皮肾镜取石术（PCNL）患者在俯卧位时头部向外侧旋转45°对上方眼和下方眼眼内压升高的影响。
45例患者随机分为2组。在手术开始前，记录患者双侧仰卧位时的眼内压。患者转为俯卧位。头部置于俯卧位头枕上，不对外眼进行直接压迫。第一组患者保持严格的俯卧中立位，而第二组患者俯卧时头部向右侧旋转45°。手术结束时，患者转为仰卧位并立即测量其眼内压。
在人口统计学、手术时间、失血量和液体输入数据方面无差异。两组患者俯卧位手术后的眼内压值均较术前显著升高（p < 0.05）。俯卧位手术后，第二组上方眼的眼内压值显著低于第一组以及第二组下方眼（p < 0.05）。
俯卧位会使眼内压升高。在头部向外侧旋转45°的俯卧位患者中，上方眼的眼内压显著较低。
