Effect of Head Position on Intraocular Pressure During Lumbar Spine Fusion

Emery, Sanford E.; Daffner, Scott D.; Ellison, Matthew; Grose, Brian W.; Hobbs, Gerald R.; Clovis, Nina

doi:10.2106/jbjs.o.00091

Cited by 30 publications

(34 citation statements)

References 12 publications

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“…Postoperative vision loss (POVL) is a devastating complication of surgery that may result in permanent blindness in the patient. Postoperative vision loss occurs most frequently during spine surgery (Emery et al, 2015) and has a prevalence of 0.0028% - Research Gate databases were utilized during this systematic review. The PRISMA 27item checklist and four-phase flow diagram were followed in order to provide for a method of research while decreasing bias during the systematic review process.…”

Section: Discussionmentioning

confidence: 99%

“…In a study by Kamel and Barnette (2014), the prevalence rate of POVL associated with spine surgery was discovered to be 0.0028%-0.2%. loss resulting from spine surgery may develop due to ION, central retinal artery occlusion, cortical blindness and posterior reversible encephalopathy (Emery et al, 2015). For purposes of this research, ION will be discussed in further detail.…”

Section: Incidence Of Povlmentioning

confidence: 99%

“…Inability to identify the capacity of reverse trendelenburg positioning to prevent POVL as the complication did not occur in any subjects in the study. Inability to determine effects on IOP after 120 minutes Emery, S. E., Daffner, S. D., France, J. C., Ellison, M., Grose, B. W., Hobbs, G. R., & Clovis, N. B. (2015).…”

Section: Recommendations and Implications For Advanced Nursing Practicementioning

confidence: 99%

“…Postoperative vision loss occurs most frequently during spinal surgery (Emery, Daffner, France, Ellison, Grose, Hobbs, & Clovis, 2015). A systematic review by Kamel and Barnette (2014) explained the importance of intraoperative positioning of patients in the operating room.…”

mentioning

confidence: 99%

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The Effect of Head Inclination on Intraocular Pressure in the Prone Position

Marzilli¹

2017

Preprint

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Postoperative vision loss (POVL) is a devastating complication of spine surgery in the prone position that may result in permanent blindness. Prone position is one of the major factors contributing to the development of increased intraocular pressure (IOP), which leads to POVL. The purpose of this systematic review was to determine the impact of head inclination on IOP in surgical patients positioned in the prone reverse Trendelenburg position compared to patients in the in the prone horizontal position. The CINHAL, EBSCOhost, Pubmed, Academic search complete, MEDLINE, Google scholar and Research Gate databases were utilized during this systematic review and the PRISMA 27-item checklist and four-phase flow diagram were used as well as the CASP tool for critically analyzing randomized controlled trials. Four studies met the inclusion and exclusion criteria and these studies were reviewed and analyzed in depth. Cross study analysis revealed that the reverse Trendelenburg position ameliorated increases in IOP in three out of four of the studies and IOP increased over time in three out of four of the studies. Certified registered nurse anesthetists (CRNAs) may decrease the patient's risk for POVL by maintaining the reverse Trendelenburg position during prone spine surgery and by using a tonometer device for measuring intraocular pressure. By adopting these new practices, CRNAs may provide the highest quality care for their patients.

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Section: Discussionmentioning

confidence: 99%

Section: Incidence Of Povlmentioning

confidence: 99%

Section: Recommendations and Implications For Advanced Nursing Practicementioning

confidence: 99%

mentioning

confidence: 99%

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The Effect of Head Inclination on Intraocular Pressure in the Prone Position

Marzilli¹

2017

Preprint

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“…The patient was positioned in 5-degree reverse Trendelenburg because elevating the head above the heart helps reduce venous congestion in the eyes and orbits and decreases intraocular and intraorbital pressure. 17,18 In this scenario, the patient's head was positioned in the midline, or neutral, position to help with reducing the risk for cerebral ischemia 19,20 and to maintain Editor's note: Syntegrity is a registered trademark and ORNurseLink is a trademark of AORN, Inc, Denver, CO.…”

Section: Prone Positionmentioning

confidence: 99%

Guideline Implementation: Positioning the Patient

Burlingame¹

2017

AORN Journal

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Every surgical procedure requires positioning the patient; however, all surgical positions are associated with the potential for the patient to experience a positioning injury. The locations and types of potential injuries (eg, stretching, compression, pressure injury) depend on the position. Factors that may increase the patient's risk for an injury are the length of the procedure and risk factors inherent to the patient (eg, weight, age, frailty). AORN's updated "Guideline for positioning the patient" provides guidance on injury prevention practices for all surgical positions including supine, Trendelenburg, reverse Trendelenburg, lateral, lithotomy, prone, and sitting positions and modifications of these positions. This article focuses on the key points of the guideline covering the use of prophylactic dressings, neurophysiological monitoring, and safely positioning the patient in the supine and prone positions. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures.

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Guidelines in Practice: Positioning the Patient

Speth¹

2023

AORN Journal

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Positioning the patient is an important perioperative task; the recently updated AORN “Guideline for positioning the patient” provides perioperative personnel with background information and evidence‐based best practices for perioperative patient positioning and focuses on maintaining patient and staff member safety. The revised guideline includes recommendations for placing patients safely in a variety of positions and avoiding positioning injuries, such as postoperative vision loss. This article provides an overview of positioning recommendations for assessing patients’ risk for injury, implementing safe positioning practices, placing patients in the Trendelenburg position, and preventing intraocular injuries. It also includes a patient‐focused scenario on preventing adverse events associated with the Trendelenburg position that aligns with information discussed in the article. Perioperative nurses should review the guideline in its entirety and implement appropriate recommendations for positioning patients during procedures.

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Effect of Head Position on Intraocular Pressure During Lumbar Spine Fusion

Cited by 30 publications

References 12 publications

The Effect of Head Inclination on Intraocular Pressure in the Prone Position

The Effect of Head Inclination on Intraocular Pressure in the Prone Position

Guideline Implementation: Positioning the Patient

Guidelines in Practice: Positioning the Patient

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