The Effect of Positional Change During Laparoscopic Surgery on Intraocular Pressure.
10.3341/jkos.2011.52.10.1208
- Author:
Hae Yoon SONG
1
;
Jong Woo CHOI
;
Jeong Do KWON
Author Information
1. Department of Ophthalmology, Wallace Memorial Baptist Hospital, Busan, Korea. kjdeye@naver.com
- Publication Type:Original Article
- Keywords:
Abdominal pressure;
Intraocular pressure;
Laparoscopic surgery;
Positional change
- MeSH:
Anesthesia, General;
Appendectomy;
Cholecystectomy;
Cholecystectomy, Laparoscopic;
Head;
Humans;
Intraocular Pressure;
Laparoscopy;
Pneumoperitoneum
- From:Journal of the Korean Ophthalmological Society
2011;52(10):1208-1214
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The present study proposes to examine the change of IOP in response to the rise of abdominal pressure and in response to position change during laparoscopic surgery. METHODS: The subjects of the present study included 28 patients who had laparoscopic appendectomy and 20 patients who had laparoscopic cholecystectomy. In both groups, the IOP was measured before surgery, after general anesthesia, after the occurrence of pneumoperitoneum, after position change according to operative method, after the removal of pneumoperitoneum and under general anesthesia. RESULTS: When comparing the IOP before and after the occurrence of pneumoperitoneum, the IOP after the occurrence increased by 3.70 +/- 0.96 mm Hg in the appendectomy group and by 3.15 +/- 0.5 mm Hg in the cholecystectomy group. After the occurrence of pneumoperitoneum, the IOP measured in the head-low position was 3.25 +/- 0.16 mm Hg higher than measured in the level position in the appendectomy group, and the IOP measured in the head-high position was 2 +/- 0.12 mm Hg lower than measured in the level position in the cholecystectomy group. Between the 2 groups, there was a significant difference of 6.5 mm Hg in IOP according to the change of head position. CONCLUSIONS: In the present study, the occurrence of pneumoperitoneum in laparoscopic surgery increased IOP, and position change according to operative method also changed IOP. In addition, IOP was significantly different between the 2 groups. In order to prevent the patient from being exposed to high IOP for a long period during laparoscopic surgery, keeping the duration of pneumoperitoneum and a head-low position to a minimum may be helpful.
