A Prospective Study of the Effects of General Anesthesia on Intraocular Pressure in Healthy Children
Purpose: To determine the effect of general anesthesia on intraocular pressure (IOP) in children with no intraocular pathology and determine which postanesthetic time point is most predictive of preinduction IOP. Design: Prospective observational study. Participants: Children with no intraocular pat...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-05-01
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| Series: | Ophthalmology Science |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666914523001872 |
| _version_ | 1797347084820545536 |
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| author | Julius T. Oatts, MD Shiya Shen, MD Hui Zhu, MD Qi Gong, MD Yinxi Yu, MS Gui-shuang Ying, PhD Ying Han, MD, PhD Hu Liu, PhD |
| author_facet | Julius T. Oatts, MD Shiya Shen, MD Hui Zhu, MD Qi Gong, MD Yinxi Yu, MS Gui-shuang Ying, PhD Ying Han, MD, PhD Hu Liu, PhD |
| author_sort | Julius T. Oatts, MD |
| collection | DOAJ |
| description | Purpose: To determine the effect of general anesthesia on intraocular pressure (IOP) in children with no intraocular pathology and determine which postanesthetic time point is most predictive of preinduction IOP. Design: Prospective observational study. Participants: Children with no intraocular pathology ≤ 18 years scheduled for general anesthesia as part of their routine care followed by a pediatric ophthalmologist at Nanjing Medical University. Methods: Participants underwent a standardized general anesthetic protocol using a mask induction with sevoflurane and propofol maintenance. Intraocular pressure was measured at the following 7 time points: preinduction (taken in the preoperative area), postinduction minutes 1, 3, and 5, and postairway placement minutes 1, 3, and 5 for a total time period of 10 minutes after induction. A generalized estimating equation was used to evaluate the effect of anesthesia on IOP and the effect of patient factors (age, gender, vital signs, and airway type) on preanesthetic and postanesthetic IOP. An IOP prediction model was developed using the postanesthesia IOP measurements for predicting preinduction IOP. Main Outcome Measures: Intraocular pressure and change in IOP at prespecified time points. Results: Eighty-five children were enrolled with a mean ± standard deviation (SD) age of 7.5 ± 2.9 years. Mean ± SD preinduction IOP was 20.1 ± 3.7 mmHg. Overall, IOP was lowest at 3 minutes postinduction, decreased to a mean of 13.4 ± 3.7 mmHg (P < 0.001). After this, IOP rose 5 minutes postinduction to 16.5 ± 4.2 mmHg, which did not reach preinduction IOP levels (P < 0.001). The IOP prediction model showed that combining 1 minute postinduction and 3 minutes postairway was most predictive (R2 = 0.13), whereas 1 minute postairway was least predictive of preinduction IOP (R2 = 0.01). Conclusions: After the induction of general anesthesia in children, IOP temporarily decreases with a trough at 3 minutes postinduction before increasing and remaining stable just below preinduction levels. Intraocular pressure measurements taken 1 minute after induction with 3 minutes after airway placement are most predictive of preinduction IOP, though predictive value is relatively low. Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article. |
| first_indexed | 2024-03-08T11:42:44Z |
| format | Article |
| id | doaj.art-bc849b7ae0224c378e01ee79e1daefbd |
| institution | Directory Open Access Journal |
| issn | 2666-9145 |
| language | English |
| last_indexed | 2024-03-08T11:42:44Z |
| publishDate | 2024-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Ophthalmology Science |
| spelling | doaj.art-bc849b7ae0224c378e01ee79e1daefbd2024-01-25T05:23:48ZengElsevierOphthalmology Science2666-91452024-05-0143100455A Prospective Study of the Effects of General Anesthesia on Intraocular Pressure in Healthy ChildrenJulius T. Oatts, MD0Shiya Shen, MD1Hui Zhu, MD2Qi Gong, MD3Yinxi Yu, MS4Gui-shuang Ying, PhD5Ying Han, MD, PhD6Hu Liu, PhD7Department of Ophthalmology, University of California, San Francisco, San Francisco, California; Correspondence: Julius T. Oatts, MD, Department of Ophthalmology, University of California, San Francisco, 490 Illinois Street, San Francisco, CA 94158.Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, ChinaDepartment of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, ChinaDepartment of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, ChinaCenter for Preventive Ophthalmology and Biostatistics, Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PennsylvaniaCenter for Preventive Ophthalmology and Biostatistics, Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PennsylvaniaDepartment of Ophthalmology, University of California, San Francisco, San Francisco, CaliforniaDepartment of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China; Hu Liu, PhD, Nanjing Medical University, 140 Hanzhong Rd, Gu Lou Qu, Nan Jing Shi, Jiang Shu Sheng, China 210029.Purpose: To determine the effect of general anesthesia on intraocular pressure (IOP) in children with no intraocular pathology and determine which postanesthetic time point is most predictive of preinduction IOP. Design: Prospective observational study. Participants: Children with no intraocular pathology ≤ 18 years scheduled for general anesthesia as part of their routine care followed by a pediatric ophthalmologist at Nanjing Medical University. Methods: Participants underwent a standardized general anesthetic protocol using a mask induction with sevoflurane and propofol maintenance. Intraocular pressure was measured at the following 7 time points: preinduction (taken in the preoperative area), postinduction minutes 1, 3, and 5, and postairway placement minutes 1, 3, and 5 for a total time period of 10 minutes after induction. A generalized estimating equation was used to evaluate the effect of anesthesia on IOP and the effect of patient factors (age, gender, vital signs, and airway type) on preanesthetic and postanesthetic IOP. An IOP prediction model was developed using the postanesthesia IOP measurements for predicting preinduction IOP. Main Outcome Measures: Intraocular pressure and change in IOP at prespecified time points. Results: Eighty-five children were enrolled with a mean ± standard deviation (SD) age of 7.5 ± 2.9 years. Mean ± SD preinduction IOP was 20.1 ± 3.7 mmHg. Overall, IOP was lowest at 3 minutes postinduction, decreased to a mean of 13.4 ± 3.7 mmHg (P < 0.001). After this, IOP rose 5 minutes postinduction to 16.5 ± 4.2 mmHg, which did not reach preinduction IOP levels (P < 0.001). The IOP prediction model showed that combining 1 minute postinduction and 3 minutes postairway was most predictive (R2 = 0.13), whereas 1 minute postairway was least predictive of preinduction IOP (R2 = 0.01). Conclusions: After the induction of general anesthesia in children, IOP temporarily decreases with a trough at 3 minutes postinduction before increasing and remaining stable just below preinduction levels. Intraocular pressure measurements taken 1 minute after induction with 3 minutes after airway placement are most predictive of preinduction IOP, though predictive value is relatively low. Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.http://www.sciencedirect.com/science/article/pii/S2666914523001872ChildrenGeneral anesthesiaIntraocular pressurePediatric ophthalmology |
| spellingShingle | Julius T. Oatts, MD Shiya Shen, MD Hui Zhu, MD Qi Gong, MD Yinxi Yu, MS Gui-shuang Ying, PhD Ying Han, MD, PhD Hu Liu, PhD A Prospective Study of the Effects of General Anesthesia on Intraocular Pressure in Healthy Children Ophthalmology Science Children General anesthesia Intraocular pressure Pediatric ophthalmology |
| title | A Prospective Study of the Effects of General Anesthesia on Intraocular Pressure in Healthy Children |
| title_full | A Prospective Study of the Effects of General Anesthesia on Intraocular Pressure in Healthy Children |
| title_fullStr | A Prospective Study of the Effects of General Anesthesia on Intraocular Pressure in Healthy Children |
| title_full_unstemmed | A Prospective Study of the Effects of General Anesthesia on Intraocular Pressure in Healthy Children |
| title_short | A Prospective Study of the Effects of General Anesthesia on Intraocular Pressure in Healthy Children |
| title_sort | prospective study of the effects of general anesthesia on intraocular pressure in healthy children |
| topic | Children General anesthesia Intraocular pressure Pediatric ophthalmology |
| url | http://www.sciencedirect.com/science/article/pii/S2666914523001872 |
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