Effect of general anaesthesia on intraocular pressure in paediatric patients: a systematic review

Abstract

Objectives Assessment of the impact of general anaesthetic agents on intraocular pressure (IOP) in children via systematic review. Methods Pubmed, Embase, and CENTRAL databases were systematically searched to identify randomised controlled trials, prospective, and interventional studies. The search included all studies through October 5, 2018 with no date or language restrictions. A linear mixed-effects regression analysis was performed to study the change in IOP after general anaesthesia (GA). ResultsThe strategy identified 518 studies that met search criteria. Six studies (531 eyes) were included for quantitative synthesis. Seven categories of mixed and non-mixed induction and maintenance agents were compared. When assessing all agents utilising a model of mean IOP as a function of time, IOP decreased after induction phase at a rate of −0.59 ± 0.19 mmHg/min (P value = 0.006). Conclusions This systematic review showed that most anaesthetic agents significantly decrease IOP over time after the induction phase of general anaesthesia in children. An understanding of the effects of GA on IOP is critical for those performing paediatric ophthalmic examinations under anaesthesia.

Does Practitioner Experience Affect Intraocular Pressure After Endotracheal Intubation?

“…In our study, as compatible with other studies, IOP values were found to be low after induction and high after intubation compared to pre-induction values in less than three-year assistant groups [ 1 , 2 , 10 , 11 ]. This increase in IOP is within normal limits.…”

“…Tracheal intubation can cause an increase in intracranial pressure, which can lead to an increase in IOP. However, it is important to note that the effect of IOP can vary greatly between patients and depends on several factors, such as the individual's anatomy and the method of intubation [ 1 , 2 , 10 , 11 ].…”

“…Some anesthetic agents can cause a decrease in IOP due to vasodilation and decreased production of aqueous humor. On the other hand, certain anesthetic agents and surgical positions can increase IOP [2]. 1 2…”

Transconjunctival XEN45 implantation for secondary open-angle glaucoma management in a pediatric patient with WAGR syndrome

“…Multiple factors can affect IOP pressure readings before surgery such as breath-holding, Valsalva maneuvers, corneal irregularities, and inhalational anesthetic agents. 8 , 9 As inhalational anesthetics can significantly impact IOP, 9 the IOP reading OD prior to surgery did not guide treatment. Rather, persistently elevated pressures in clinic with the presence of glaucomatous damage indicated necessity for surgery.…”

Safety of intravitreally delivered AAV2 vector‐mediated multi‐characteristic opsin genetic construct in wild type beagle dogs

“…31,32 Because the dogs were also anesthetized before the IVT injections, the residual effects of the anesthetics could also have lowered the IOP as has been reported in many mammalian species. [33][34][35] Subsequently, a small insignificant increase in IOP was observed in the injected eye from day 29 to week 8. However, this increase was not significantly different from the baseline or from the AAV2-injected eyes.…”