Yamada Makiko Hardy, Takazawa Tomonori, Iriuchijima Nobuhisa, Horiuchi Tatsuo, Saito Shigeru
Department of Anesthesiology, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, 371-8511, Japan.
Department of Anesthesiology, Kiryu Kosei General Hospital, 6-3 Orihime-cho, Kiryu, 376-0024, Japan.
J Clin Monit Comput. 2016 Dec;30(6):869-874. doi: 10.1007/s10877-015-9787-3. Epub 2015 Oct 6.
Intraocular pressure (IOP) has been shown to change with body position. Several studies have shown that the lateral decubitus position (LDP) is associated with a significant increase in IOP in the dependent eye. However, whether anesthetic agents alter IOP in the LDP remains unclear. This study investigated the effect of sevoflurane and propofol anesthesia on IOP in the LDP. A total of 28 patients undergoing surgery in the LDP were included. Patients were randomly allocated to sevoflurane or propofol groups. IOP in both eyes was recorded and compared between groups at five time points: after anesthesia induction, after endotracheal intubation, at 5 min and 1 h after a positional change to the LDP, and 5 min after returning to the supine position. In the sevoflurane group, IOP was significantly increased in both dependent and non-dependent eyes 1 h after changing to the LDP. In the propofol group, IOP decreased in both dependent and non-dependent eyes after tracheal intubation, but did not increase after changing to the LDP. The number of patients in whom IOP increased to ≥28 mmHg was greater in the sevoflurane group than in the propofol group. Propofol may be better than sevoflurane for the maintenance of anesthesia in the LDP. Monitoring of IOP in the LDP might help avoid ophthalmic complications.
眼内压（IOP）已被证明会随体位改变。多项研究表明，侧卧位（LDP）会使受压眼的眼内压显著升高。然而，麻醉剂是否会改变侧卧位时的眼内压仍不清楚。本研究调查了七氟醚和丙泊酚麻醉对侧卧位时眼内压的影响。共纳入28例接受侧卧位手术的患者。患者被随机分配至七氟醚组或丙泊酚组。记录双眼眼内压，并在五个时间点比较两组眼内压：麻醉诱导后、气管插管后、改为侧卧位后5分钟和1小时，以及恢复仰卧位后5分钟。在七氟醚组，改为侧卧位1小时后，受压眼和非受压眼的眼内压均显著升高。在丙泊酚组，气管插管后受压眼和非受压眼的眼内压均降低，但改为侧卧位后未升高。七氟醚组眼内压升高至≥28 mmHg的患者数量多于丙泊酚组。对于侧卧位手术的麻醉维持，丙泊酚可能优于七氟醚。监测侧卧位时的眼内压可能有助于避免眼科并发症。
