Arslan-Carlon Vittoria, Walline Maria C, Seier Kenneth, Tan Kay See, Abramson David H
Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Department of Anesthesiology, Montefiore Medical Center, New York, New York, USA.
Ocul Oncol Pathol. 2020 May;6(3):203-209. doi: 10.1159/000500593. Epub 2019 Oct 30.
Dilating eye drops are routinely used in pediatric retinoblastoma patients during anesthetized ophthalmologic exams. Information on the systemic effects of ocular mydriatics, especially in anesthetized pediatric patients, is limited.
The primary aim of this study was to analyze hemodynamic changes during mydriatic eye drop administration in anesthetized pediatric patients.
A retrospective chart review was performed for pediatric retinoblastoma patients who underwent MRI with anesthesia. Baseline blood pressure (BP) and heart rate (HR) were charted for each patient at induction. HR and mean arterial pressure (MAP) measurements were recorded at 5, 10, 15, 30, and 45 min after eye drop administration. Secondarily, we included data from 15 patients who received dilating eye drops while under sevoflurane general anesthetic. All patients were dilated with phenylephrine 2.5 or 10% (depending on age) and tropicamide 1%.
The final analysis included 176 anesthesia encounters. The results demonstrate no statistically significant deviation of more than 20% from baseline for either HR or MAP. Additionally, we did not detect any difference between patients who were anesthetized with propofol versus sevoflurane.
We did not observe significant hemodynamic instability with administration of dilating eye drops during propofol anesthesia.
在儿科视网膜母细胞瘤患者进行麻醉下眼科检查时，散瞳眼药水被常规使用。关于眼部散瞳剂的全身效应的信息有限，尤其是在麻醉的儿科患者中。
本研究的主要目的是分析麻醉的儿科患者使用散瞳眼药水期间的血流动力学变化。
对接受麻醉下MRI检查的儿科视网膜母细胞瘤患者进行回顾性病历审查。记录每位患者诱导时的基线血压（BP）和心率（HR）。在滴眼药水后5、10、15、30和45分钟记录HR和平均动脉压（MAP）测量值。其次，我们纳入了15例在七氟醚全身麻醉下接受散瞳眼药水的患者的数据。所有患者均用2.5%或10%的去氧肾上腺素（根据年龄）和1%的托吡卡胺散瞳。
最终分析包括176次麻醉记录。结果表明，HR或MAP与基线相比，在统计学上没有超过20%的显著偏差。此外，我们没有检测到丙泊酚麻醉患者与七氟醚麻醉患者之间的任何差异。
在丙泊酚麻醉期间使用散瞳眼药水时，我们未观察到明显的血流动力学不稳定。
