Zuche H, Morinello E, Viestenz A, Fiorentzis M, Seitz B, Volk T, Viestenz A
Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes, UKS, Kirrberger Str. 100, Geb. 22, 66424, Homburg/Saar, Deutschland.
Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum des Saarlandes, UKS, Homburg/Saar, Deutschland.
Ophthalmologe. 2015 Sep;112(9):764-9. doi: 10.1007/s00347-014-3180-3.
Measurement of the intraocular pressure (IOP) is an important tool for glaucoma diagnostics in children or patients with impaired cooperation. General anesthesia (GA) may significantly influence the IOP. This study aimed to evaluate the reduction of IOP during GA.
The IOP was measured in 229 patients in a recumbent position in the non-operated eye prior to and 5 min after the beginning of GA with a dynamic contour tonometer (DCT).
The average IOP decreased from 19.9 ± 3.7 mmHg prior to GA to 14.1 ± 3.5 mmHg 5 min after beginning GA (p < 0.0001, IOP decrease 30 %). The GA caused a decrease of up to 2 mmHg in 6.1 %, 2-4 mmHg in 18.8 %, 4-6 mmHg in 21.0 %, 6-8 mmHg in 36.6 %, 8-10 mmHg in 13.6 %, 10-12 mmHg in 2.2 % and more than 12 mmHg in 1.7 % of the eyes. The ocular pulse amplitude (OPA) decreased from a mean of 3.4 ± 1.5 mmHg to 1.9 ± 1.0 mmHg (p < 0.0001, OPA decrease 41 %) under GA.
A significant decrease of IOP (mean 6 mmHg) occurs during GA and under extreme conditions up to 13.8 mmHg. A decrease of OPA of 1.5 mmHg should be taken into consideration for patients under general anesthesia and under extreme conditions up to 7 mmHg.
测量眼压（IOP）是儿童青光眼诊断或合作能力受损患者的重要工具。全身麻醉（GA）可能会显著影响眼压。本研究旨在评估全身麻醉期间眼压的降低情况。
使用动态轮廓眼压计（DCT），在229例患者仰卧位时，于全身麻醉开始前和开始后5分钟测量其非手术眼的眼压。
全身麻醉前平均眼压为19.9±3.7 mmHg，全身麻醉开始后5分钟降至14.1±3.5 mmHg（p<0.0001，眼压降低30%）。全身麻醉使6.1%的眼睛眼压降低高达2 mmHg，18.8%降低2 - 4 mmHg，21.0%降低4 - 6 mmHg，36.6%降低6 - 8 mmHg，13.6%降低8 - 10 mmHg，2.2%降低10 - 12 mmHg，1.7%降低超过12 mmHg。全身麻醉下，眼动脉搏动幅度（OPA）从平均3.4±1.5 mmHg降至1.9±1.0 mmHg（p<0.0001，OPA降低41%）。
全身麻醉期间眼压显著降低（平均6 mmHg），在极端情况下可达13.8 mmHg。对于全身麻醉患者，应考虑眼动脉搏动幅度降低1.5 mmHg，在极端情况下可达7 mmHg。
