Effect of positive end-expiratory pressure administration on intraocular pressure in laparoscopic cholecystectomy

Karabayırlı, Safinaz; Çimen, Nuran Kavun; Muslu, Bünyamin; Tenlik, Aylin; Gözdemir, Muhammet; Sert, Hüseyin; Hepşen, İbrahim F.

doi:10.1097/eja.0000000000000459

Cited by 8 publications

(11 citation statements)

References 8 publications

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“…Hwang et al (18) reported a decrease in IOP among patients undergoing laparoscopic cholecystectomy in head-up position compared with patients undergoing laparoscopic surgeries other than cholecystectomy in the Trendelenburg position.. Moreover, Karabayirli et al (19) found that the IOP remained within the normal range during laparoscopic cholecystectomy with or without the administration of 10 cm H 2 0 PEEP. However, in all these studies, the study subjects had normal BMI.…”

Section: Discussionmentioning

confidence: 99%

Does obesity affect intraocular pressure during laparoscopic surgery?

Başaran

Aysun

Soylu

et al. 2019

Arquivos Brasileiros De Oftalmologia

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Obesity is accepted as a risk factor for postoperative visual loss due to possible perioperative elevations in intraocular pressure. This study investigated whether intraocular pressure changes differed according to the body mass index of patients undergoing laparoscopic cholecystectomy. Methods: Thirty obese and 30 non-obese patients (body mass index cutoff point, 30 kg/m 2) undergoing laparoscopic cholecystectomy were enrolled. Intraocular pressure was measured at baseline (T1), after induction of anesthesia (T2), 5 min after initiation of mechanical ventilation (T3), 5 min after pneumoperitoneum inflation (T4), 5 min after the patient was placed in the head-up position (T5), 5 min after deflation with the patient in the supine position (T6), and 5 min after extubation with the patient in the 30 degrees upright position (T7). Results: The mean intraocular pressure values of the obese and non-obese groups were similar at T1 (16.60 ± 2.93 and 16.87 ± 2.85 mmHg respectively). In both groups, intraocular pressure decreased following initiation of anesthesia (T2) (p<0.001, T2 vs T1). Intraocular pressure values at T7 were significantly higher than those at T1 in the obese (20.38 ± 4.11 mmHg, p<0.001) and non-obese (20.93 ± 4.37 mmHg, p<0.01) groups. There were no significant differences between intraocular pressure values of obese and non-obese patients at any time point. Conclusions: Obesity is not correlated with intraocular pressure during short laparoscopic surgeries with the patient in the head-up position.

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Section: Discussionmentioning

confidence: 99%

Does obesity affect intraocular pressure during laparoscopic surgery?

Başaran

Aysun

Soylu

et al. 2019

Arquivos Brasileiros De Oftalmologia

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“…Два столетия назад ученые исследовали влияние венозного кровотока на состояние ВГД и пришли к выводу, что затруднение венозного кровотока в яремных венах повышает уровень офтальмотонуса [4][5][6]. Известно, что повышение внутриплеврального давления, сопряженное с сокращением мышц брюшной полости (кашель, натуживание), а также увеличение внутрибрюшного давления (искусственный пневмоперитонеум при выполнении лапароскопических операций) приводят к резкому кратковременному возрастанию центрального венозного давления, что сопровождается соответственным снижением венозного возврата крови к сердцу и повышением ВГД [6][7][8][9][10]. В зарубежной и отечественной литературе опубликованы работы, посвященные проблемам взаимосвязи изменений внутриглазного, внутригрудного и внутрибрюшного давления.…”

Section: Abstract: Glaucoma Venous Circulation Disturbance Anal Steunclassified

A case of progressive glaucoma against the background of chronic constipation

et al. 2017

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The authors describe a case of severe glaucoma in the only seeing eye of a patient with venous circulation disturbance resulting from a chronic anal fissure complicated with progressive anal stenosis, severe sphincter spasm, and pain syndrome. The article presents the results of multiple clinical ophthalmological tests and instrumental examinations performed before and after surgical intervention that evidence the importance of venous circulation disturbances for glaucoma development.

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“…Moreover, the intraocular pressure (IOP) is elevated because the increase in central venous pressure that occurs in the steep Trendelenburg position impairs aqueous outflow into the episcleral venous circulation, which may cause postoperative ophthalmological complications including exacerbate preexisting glaucoma, which may lead to a decrement in postoperative visual acuity and ischemic optic neuropathy. [6,7] Also, the intracranial pressure (ICP), which can be commonly evaluated by noninvasive ocular sonography, is increased during pneumoperitoneum with steep Trendelenburg position. [8–10] Elevated ICP result in delayed emergence from general anesthesia, postoperative delirium, declined cognitive function, and rarely neurologic deficit.…”

Section: Introductionmentioning

confidence: 99%

“…[8–10] Elevated ICP result in delayed emergence from general anesthesia, postoperative delirium, declined cognitive function, and rarely neurologic deficit. [6,7,11]…”

Section: Introductionmentioning

confidence: 99%

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Effects of positive end-expiratory pressure on intraocular pressure and optic nerve sheath diameter in robot-assisted laparoscopic radical prostatectomy

You

Song²,

Kim³

et al. 2019

Medicine

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Background: There has been no study of the effect of post end-expiratory pressure (PEEP) on intraocular or intracranial pressure during pneumoperitoneum with steep Trendelenburg positioning. We investigated the effects of 5 cmH 2 O of PEEP on intraocular pressure and optic nerve sheath diameter as a surrogate for intracranial pressure in robot-assisted laparoscopic radical prostatectomy. Methods: Fifty patients scheduled for robot-assisted laparoscopic radical prostatectomy were divided into a zero-PEEP (ZEEP) group and a 5 cmH 2 O of PEEP (PEEP) group. Intraocular pressure, optic nerve sheath diameter, and respiratory and hemodynamic parameters were measured before induction (T0), 10 minutes after induction of general anesthesia in the supine position before CO 2 insufflation (T1), 5 minutes (T2), and 30 minutes (T3) after steep Trendelenburg positioning with pneumoperitoneum, after desufflation of pneumoperitoneum in the supine position (T4), and after 30 minutes in the recovery room postoperatively (T5). Results: There was no significant difference in intraocular pressure or optic nerve sheath diameter between the groups during the study. The partial pressure of arterial oxygen and dynamic lung compliance at T1, T2, T3, and T4 were significantly higher in the PEEP than in the ZEEP group. There was no difference in mean arterial pressure or heart rate between groups at any time. Conclusion: Applying 5 cmH 2 O of PEEP did not increase intraocular pressure or optic nerve sheath diameter during pneumoperitoneum with steep Trendelenburg positioning in robot-assisted laparoscopic radical prostatectomy. These results suggest that low PEEP can be safely applied during surgery with pneumoperitoneum and steep Trendelenburg positioning in patients without preexisting eye disease and brain pathology.

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Effect of positive end-expiratory pressure administration on intraocular pressure in laparoscopic cholecystectomy

Cited by 8 publications

References 8 publications

Does obesity affect intraocular pressure during laparoscopic surgery?

Does obesity affect intraocular pressure during laparoscopic surgery?

A case of progressive glaucoma against the background of chronic constipation

Effects of positive end-expiratory pressure on intraocular pressure and optic nerve sheath diameter in robot-assisted laparoscopic radical prostatectomy

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