scholarly journals Effects of Systemic Administration of Dexmedetomidine on Intraocular Pressure and Ocular Perfusion Pressure during Laparoscopic Surgery in a Steep Trendelenburg Position: Prospective, Randomized, Double-Blinded Study

2016 ◽  
Vol 31 (6) ◽  
pp. 989 ◽  
Author(s):  
Jin Joo ◽  
Hyunjung Koh ◽  
Kusang Lee ◽  
Jaemin Lee
Keyword(s):  
Intraocular Pressure ◽  
Laparoscopic Surgery ◽  
Perfusion Pressure ◽  
Systemic Administration ◽  
Ocular Perfusion Pressure ◽  
Trendelenburg Position ◽  
Ocular Perfusion ◽  
Steep Trendelenburg Position ◽  
Blinded Study ◽  
Double Blinded

scholarly journals Ocular blood flow in steep Trendelenburg positioning during robotic-assisted radical prostatectomy

2017 ◽  
Vol 28 (3) ◽  
pp. 333-338 ◽  
Author(s):  
Christian L. Demasi ◽  
Francesco Porpiglia ◽  
Augusto Tempia ◽  
Savino D’Amelio
Keyword(s):  
Blood Flow ◽  
Radical Prostatectomy ◽  
Perfusion Pressure ◽  
Ocular Blood Flow ◽  
Ocular Perfusion Pressure ◽  
Trendelenburg Position ◽  
Robotic Assisted ◽  
Ocular Perfusion ◽  
Steep Trendelenburg Position ◽  
Pulsatile Ocular Blood Flow

Purpose: Several ischemic optic neuropathies that occurred during robotic-assisted laparoscopic radical prostatectomy (RALRP) have been reported to be due to the Trendelenburg position, which lowers ocular perfusion pressure (OPP). We examined changes in pulsatile ocular blood flow (POBF) and its correlation with OPP during RALRP in the steep Trendelenburg position. Methods: Pulsatile ocular blood flow and intraocular pressure (IOP) were measured in 50 patients by the OBF Langham System 5 times during RALRP. The mean arterial blood pressure (MAP), heart rate, plateau airway pressure, and end-tidal CO2 (EtCO2) at each time point were recorded. Ocular perfusion pressure was calculated from simultaneous IOP and MAP measurements. Results: Pulsatile ocular blood flow was 15.53 ± 3.32 µL/s at T0, 18.99 ± 4.95 µL/s at T1, 10.04 ± 3.24 µL/s at T2, 11.45 ± 3.02 µL/s at T3, and 15.07 ± 3.81 µL/s at T4. Ocular perfusion pressure was 70.15 ± 5.98 mm Hg at T0, 64.21 ± 6.77 mm Hg at T1, 57.71 ± 7.07 mm Hg at T2, 51.73 ± 11.58 mm Hg at T3, and 64.21 ± 12.37 mm Hg at T4. Repeated-measures analysis of variance on POBF and OPP was significant (p>0.05). This difference disappeared when the correlation between MAP and POBF, EtCO2 and POBF, and EtCO2 and OPP were considered, while correlation between MAP and OPP confirmed the difference. The regression analysis between POBF and OPP showed a statistically significant difference at T0 and T3 (r = 0.047, p = 0.031 and r = 0.096, p = 0.002, respectively). Conclusions: Pulsatile ocular blood flow and OPP reached the lowest level at the end of surgery.

scholarly journals The Effect of Perioperative Fluid Management on Intraocular Pressure during Gynecologic Laparoscopic Pelvic Surgery

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Izakson Alexander ◽  
Sindawi Ahmad ◽  
Ben Shachar Inbar ◽  
Pikkel Joseph
Keyword(s):  
Intraocular Pressure ◽  
Mean Arterial Pressure ◽  
Perfusion Pressure ◽  
Fluid Management ◽  
Pelvic Surgery ◽  
Ocular Perfusion Pressure ◽  
Trendelenburg Position ◽  
Time Points ◽  
Ocular Perfusion ◽  
Management Protocol

Purpose. Visual loss is a devastating perioperative complication that can result from elevated intraocular pressure (IOP). The Trendelenburg position during surgery increases IOP. The purpose of this study was to quantify IOP changes in patients undergoing laparoscopic hysterectomy, at different time points and body positions throughout the procedure, and to compare fluctuations of IOP during the perioperative period according to two fluid management protocols.Methods. Thirty women scheduled to undergo elective gynecologic laparoscopic pelvic surgery were randomly allocated to receive a liberal or restrictive fluid management protocol. IOP, mean arterial pressure, heart rate, exhaled tidal volume, end-tidal CO2, and ocular perfusion pressure were assessed prior, during, and postsurgery, at 8 time points altogether.Results. Mean changes in IOP were similar for the two protocols; the peak IOP was at the steep (peak) Trendelenburg position. For each protocol, IOP correlated positively with mean arterial pressure, and mean blood pressure correlated with ocular perfusion pressure.Conclusion. IOP was elevated during laparoscopic pelvic surgery and particularly at the steep Trendelenburg position. No differences were found in any of the parameters examined according to a liberal or restrictive fluid management protocol.

The Effect of Prone Positioning on Intraocular Pressure in Anesthetized Patients

2001 ◽  
Vol 95 (6) ◽  
pp. 1351-1355 ◽  
Author(s):  
Mary Ann Cheng ◽  
Alexandre Todorov ◽  
René Tempelhoff ◽  
Tom McHugh ◽  
C. Michael Crowder ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Prone Position ◽  
Repeated Measures ◽  
Perfusion Pressure ◽  
Prone Positioning ◽  
Ocular Perfusion Pressure ◽  
Ocular Perfusion ◽  
American Society

Background Ocular perfusion pressure is commonly defined as mean arterial pressure minus intraocular pressure (IOP). Changes in mean arterial pressure or IOP can affect ocular perfusion pressure. IOP has not been studied in this context in the prone anesthetized patient. Methods After institutional human studies committee approval and informed consent, 20 patients (American Society of Anesthesiologists physical status I-III) without eye disease who were scheduled for spine surgery in the prone position were enrolled. IOP was measured with a Tono-pen XL handheld tonometer at five time points: awake supine (baseline), anesthetized (supine 1), anesthetized prone (prone 1), anesthetized prone at conclusion of case (prone 2), and anesthetized supine before wake-up (supine 2). Anesthetic protocol was standardized. The head was positioned with a pinned head-holder. Data were analyzed with repeated-measures analysis of variance and paired t test. Results Supine 1 IOP (13 +/- 1 mmHg) decreased from baseline (19 +/- 1 mmHg) (P < 0.05). Prone 1 IOP (27 +/- 2 mmHg) increased in comparison with baseline (P < 0.05) and supine 1 (P < 0.05). Prone 2 IOP (40 +/- 2 mmHg) was measured after 320 +/- 107 min in the prone position and was significantly increased in comparison with all previous measurements (P < 0.05). Supine 2 IOP (31 +/- 2 mmHg) decreased in comparison with prone 2 IOP (P < 0.05) but was relatively elevated in comparison with supine 1 and baseline (P < 0.05). Hemodynamic and ventilatory parameters remained unchanged during the prone period. Conclusions Prone positioning increases IOP during anesthesia. Ocular perfusion pressure could therefore decrease, despite maintenance of normotension.

scholarly journals Evaluation of the circadian fluctuations of intraocular pressure and ocular perfusion pressure in different types of glaucoma

2018 ◽  
pp. 15-18
Keyword(s):  
Intraocular Pressure ◽  
Perfusion Pressure ◽  
Ocular Blood Flow ◽  
University Hospital ◽  
Ocular Perfusion Pressure ◽  
Goldmann Tonometry ◽  
Ocular Perfusion ◽  
Objective Evidence ◽  
Different Types ◽  
Exfoliative Glaucoma

Background: Glaucoma is a frequent leading cause of blindness. Objective evidence showed that it can be secondary to optic nerve head hypoperfusion and autonomic dysfunction, not only to ocular hypertension. This makes the assessment of ocular blood flow a crucial step in the management of this disease. Aim: To investigate the circadian fluctuations of the intraocular pressure (IOP) and of the mean ocular perfusion pressure (mOPP) in patients with different types of glaucoma. Materials and methods: Sixty-five eyes of 65 glaucoma patients, managed in the Ophthalmology Department of the Careggi University Hospital, Firenze, Italy (2012-2014). Among these eyes, 22 had normotensive glaucoma (NTG), 21 hypertensive glaucoma (HTG), and 22 exfoliative glaucoma (XTG). The IOP was measured by Goldmann tonometry and the blood pressure, both systolic (sBP) and diastolic (dBP), by Riva-Rocci sphygmomanometry, at three time points (8am, 2pm, 8pm). The mOPP was then calculated according to the formula mOPP = [2/3 (2/3 dBP + 1/3sBP) - IOP]. Results: The fluctuations of IOP and mOPP were statistically significant in all the studied eyes (p<0.001 for all the comparisons). Both IOP and mOPP showed significantly larger fluctuations in the XFG eyes than in the NTG and HTG ones (p<0.001 for IOP and p=0.001 for mOPP). Conclusions: In our study, the mOPP had larger circadian fluctuations in eyes with XFG than in those with NTG and HTG. This parameter deserves to be assessed in all types of glaucoma. Key words: Glaucoma, intraocular pressure, mean ocular perfusion pressure.

Sign in / Sign up

Export Citation Format

Share Document