Polarz H, Böhrer H, von Tabouillot W, Martin E, Tetz M, Völcker H E
Klinik für Anästhesiologie, Universität Heidelberg.
Anasthesiol Intensivmed Notfallmed Schmerzther. 1995 Apr;30(2):96-8. doi: 10.1055/s-2007-996455.
To investigate the influence of isoflurane anaesthesia versus total intravenous anaesthesia with propofol/alfentanil on intraocular pressure (IOP).
40 patients undergoing ophthalmic surgery were randomly allocated to two study groups. In group 1 (n = 20), anaesthesia was induced with thiopentone 4 mg/kg and alfentanil 15 micrograms/kg. Maintenance of anaesthesia was achieved with isoflurane 0.5-0.8 Vol.% and 70% nitrous oxide in oxygen. Patients in group 2 (n = 20) received propofol 1.5 mg/kg, which was followed by a continuous infusion of 6 mg/kg/h. In addition, alfentanil 15 micrograms/kg was administered, followed by a continuous infusion of 15 micrograms/kg/h. In both groups, endotracheal intubation was facilitated by succinylcholine 1 mg/kg, and further muscle relaxation was achieved with vecuronium 0.07 mg/kg. Measurements of IOP using an applanation tonometer were taken in each patient at 10 different time points.
In both groups, there was a significant decrease in IOP after induction of anaesthesia. No significant differences in IOP occurred between groups, with patients in group 2 showing a trend towards lower IOP values.
We conclude from our results that both anaesthetic techniques can be administered if increases in IOP have to be avoided.
研究异氟烷麻醉与丙泊酚/阿芬太尼全静脉麻醉对眼压（IOP）的影响。
40例行眼科手术的患者被随机分为两个研究组。第1组（n = 20），用硫喷妥钠4mg/kg和阿芬太尼15μg/kg诱导麻醉。用0.5 - 0.8体积%的异氟烷和70%的氧化亚氮/氧气维持麻醉。第2组（n = 20）患者接受丙泊酚1.5mg/kg，随后以6mg/kg/h的速度持续输注。此外，给予阿芬太尼15μg/kg，随后以15μg/kg/h的速度持续输注。两组均用1mg/kg琥珀酰胆碱辅助气管插管，并用0.07mg/kg维库溴铵进一步实现肌肉松弛。在10个不同时间点对每位患者使用压平眼压计测量眼压。
两组在麻醉诱导后眼压均显著降低。两组间眼压无显著差异，第2组患者眼压有降低趋势。
我们从结果中得出结论，如果必须避免眼压升高，两种麻醉技术均可应用。
