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Effect of general anesthesia on intraocular pressure in Chinese children

Junpeng Wang, Hong Wei, Tieli Dong

Objective: We aimed to assess the Intraocular Pressure (IP) normal distribution amid General Anesthesia (GA) in healthy children and to evaluate contrasts in IP with respect to anesthetics utilized and estimation timepoint.

Methods: Between May 2015 and October 2015, 120 children without glaucoma history planned for nonintraocular surgeries under GA induction by sevoflurane (A) or propofol (B) while maintenance using sevoflurane+remifentanil (C) or propofol+remifentanil (D). Children were categorized into 4 groups (AC, AD, BD and BC). Haemodynamic characteristics as well as IP are studied in two eyes in 4 defined time points utilizing Perkins Applanation Tonometer: a) prior to GA induction (GA1) b) just post GA induction but prior to laryngeal mask (GA2) c) amid mechanical-ventilation (GA3) and 4) post extubating (GA4). Multiple variate repeat measure Analysis of Variance (ANOVA) was utilized to compare IP contrasts in 2 eyes at defined time points and GA amid examination period while Pearson’s correlation coefficient for additional investigation of relation among heart rates, systolic blood pressures, and IPs’.

Results: GA demonstrated significant reduction in IP. Mean IP overall estimate was 6.9 ± 3.3 mmHg and was under normal distribution. IP was noted to be 7.51 ± 2.74 mmHg amid GA1 with significant decrease (p<0.001) to 5.67 ± 2.98 mmHg amid GA2 and significant increase (p=0.011) to 6.96 ± 2.24 mmHg amid GA3 and further increase (p=0.042) to 7.95 ± 4.68 mmHg at GA4. Amid GA2, significant decrease (p<0.05) in IP in all subcategories in comparison to GA1 was observed. Amid GA3 and GA4, IP raised again in all categories. Amid GA4, IP was significantly low in AC category than BD (p<0.01) and AD categories (p=0.031). No significant contrasts in IP with respect to operation type, sex, and age was noted.

Conclusion: All in all, the study demonstrates significant reduction in IP by GA in pediatrics. No significant contrasts among subcategories at time points GA1 to GA3 was observed, however IP is fluctuating amid GA based on time points of estimation. Low IP could be measured instantly post GA induction. This ought to be contemplated while estimating IP under GA.