Journals / Medicine Science / 2019 / Cilt: 8 - Sayı: 2

Comparison of the effects of head-down and head-up position on intraocular pressure and haemodynamics during laparoscopic abdominal surgery

Pages
440–444
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

We recommend preoperative and peroperative IOP measurement in laparascopic and robotic surgery attempts, in surgical operations which are expected to last long and in old patients whether or not they have eye disease anamnesis.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:The aim of our study was to compare intraoperative changes on the haemodynamics and intraocular pressure in the head-up and head-down position in laparoscopic cholecystectomy and gynaecologic surgery.
📊
Key Findings & Data:This cohort study (prospective observational study) was made in Antalya Education and Research Hospital (Turkey) between 2015 and 2017.
💡
Conclusion & Impact:We recommend preoperative and peroperative IOP measurement in laparascopic and robotic surgery attempts, in surgical operations which are expected to last long and in old patients whether or not they have eye disease anamnesis.
🔬Design:Research Article
📍Scope:2015 Verileri
⚙️Variables:Domain Parameters

Özet

The aim of our study was to compare intraoperative changes on the haemodynamics and intraocular pressure in the head-up and head-down position in laparoscopic cholecystectomy and gynaecologic surgery. This cohort study (prospective observational study) was made in Antalya Education and Research Hospital (Turkey) between 2015 and 2017. Seventy seven patients undergoing laparoscopic cholecystectomy (head-up position, n=42 ) and laparoscopic gynecology operations (head-down position=35) were included. The intraocular pressure (IOP) was measured for both eyes at defined intervals during the procedure with Schiotz tonometer. During of surgery, heart rate, mean arterial blood pressure, sistolic arterial blood pressure, diastolic arterial blood pressure and ETCO2 were also recorded. IOP was detected to be higher in Group II at the 5th minute of CO2 insufflation (17.17±2.91) and at the 5th minute of head-down position (17.97±2.83), P<0.05. In addition, IOP measurements were recorded 14.79±4.92 for group I and 17.17±3.03 for group II significally higher immediately before post-op CO2 desufflation (P<.0.05). Statistically meaningful difference was detected between groups in terms of operation and anaesthesia processes (P=0.044, P<0.001 respectively). The patient’s position during surgery may represent a stronger risk factor for IOP increase than pneumoperitoneum-related intraabdominal pressure in surgical operations which are expected to last longer than two hours and in old patients. IOP increases with head-down position. We recommend preoperative and peroperative IOP measurement in laparascopic and robotic surgery attempts, in surgical operations which are expected to last long and in old patients whether or not they have eye disease anamnesis.

🔖

Cite This Article

ONUK, Z. A. A. (2019). Comparison of the effects of head-down and head-up position on intraocular pressure and haemodynamics during laparoscopic abdominal surgery. Medicine Science, Cilt: 8 - Sayı: 2, 440–444. https://ajindex.com/articles/277150

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (15)

  1. Molloy BL. Implications for postoperative visual loss: steep Trendelenburg position and effects on intraocular pressure. AANA J. 2011;79:115-21
  2. Lentschener C, Benhamou D, Nıessen F, et al. Intraocular pressure changes during gynaecological laparoscopy. Anaesthesia. 1996;51:1106-8.
  3. Hwank JW, Oh AY, Hwang DW, et al. Does intraocular pressure increase during laparoscopic surgeries? It depends on anesthetic drugs and the surgical position. Surg Laparosc Endosc Percutan Tech. 2013;23:229-22.
  4. Joris J, Cigarini B, Legrand M,et al. Metabolic and respiratory changes after cholecystectomy performed via laparotomy or laparoscopy. Br J Anaesth. 1992;69:341-5.
  5. Kelly DJ, Farrell SM. Physiology and Role of Intraocular Pressure in Cotemporary. Anesth Analg. 2018;126:1551-62.
  6. Hvıdberg A, Kessing SVV, Fernandes A. Effect of changes in PCO2 and body positions on intraocular pressure during general anaesthesia. Acta Ophthalmol. 1981;59:465-75.
  7. ChengYC, Li Y, Xu CT. Effects of propofol versus urapidil on perioperative hemodinamics and intraocular pressure during anesthesia and extubation in ophthalmic patients. Int J Ophthalmol. 2011;4:170-4.
  8. Joris JL, Noirot DP, Legrand MJ, et al. Hemodynamic changes during laparoscopic cholecystectomy. Anesth Analg. 1993;76:1067-71.
  9. Dubois F, Icard P, Bertholet G, Coelioscopic cholecystectomy. Ann Surg. 1990;160:485-7.
  10. Yoo YC, Shin S, Choi EK, et al. Increase in intraocular pressure is less with propofol than with sevoflurane during laparoscopic surgery in the steep Trendelenburg position. Can J Anaesth. 2014;61:322-9.
  11. Mowafi HA, Al-Ghamdi AJ, Rushood A. Intraocular pressure changes during laparoscopy in patients anesthetized with propofol total intravenous anesthesia versus isoflurane inhaled Anesthesia. Anesthesia&Analgesia. 2003;97:471-4.
  12. Rubin AM, Rials SJ, Marinchak RA, et al. The head-up tilt table test and cardiovascular neurogenic syncope. Am Heart J. 1993;125:476-82.
  13. Borahay MA, Pooja R, Patel MD. Intraocular pressure and steep trendelenburg during minimally invasive gynecologic surgery: is there a risk? J Minim Invas Gynecol. 2013;20:819-24.
  14. Montazeri K, Dchghan A, Akbari S. Increase in intraocular pressure is less with propofol and remifentanil than isoflurone with remifentanil during cataract surgery: A randomized controlled trial. Adv Biomed Res.2015;4:55. Kayacan N, Arici G, Akar M, et al. The effect of pneumoperitoneum and head-down position on intraocular pressure. Gynaecol Endos. 2002;11:383-7.
  15. Goepfert CE, Ifune C, Tempelh