Short-term changes of intraocular pressure after cervical interlaminar epidural injection: a pilot study

Kang, S.S.; Kim, I.S.; Park, J.H.; Hong, Sang-hoon; Shin, Hoon−Kyu; Song, C.; Yoo, Yongjae; Shin, Kyung-Sik

doi:10.1093/bja/aeu240

Cited by 3 publications

(1 citation statement)

References 18 publications

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“…7 Kang et al found that the IOP started increasing after the insertion of the Tuohy during a neuraxial intervention and continued to increase for 2 min after the intervention. 8 It was commonly reported in various studies and reviews that sudden IOP spikes could be observed due to the increased CSF pressure observed in neuraxial interventions. It has been reported that increased translamina cribrosa pressure could be of critical importance in patients who were at risk of loss of vision.…”

Section: Discussionmentioning

confidence: 98%

Comparison of the effects of general anesthesia and combined spinal-epidural anesthesia on intraocular pressure in lower extremity surgeries employing pneumatic tourniquets: a randomized clinical trial

Yildiz¹,

Güleç²,

Ozayar³

et al. 2023

Anaesth. pain intensive care

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Background & Objective: Induction of general anesthesia has been known to raise the intraocular pressure (IOP). The effect is more pronounced at the time of intubation. Similarly, applying pneumatic tourniquets is associated with rise in IOP. We compared the effects of general anesthesia and combined spinal-epidural anesthesia (CSEA) on IOP in lower extremity surgeries employing pneumatic tourniquets. Methodology: A total of 50 patients, aged over 18 y, completed the study. Patients were randomly divided into the general anesthesia group (Group GA) and CSEA group (Group CSE). IOP and hemodynamic parameters including systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP) and heart rate (HR),were measured at baseline (T0), and after general anesthesia induction (T1), after intubation or after initiation of CSEA (T2), after placement of tourniquet (T3), and on removal of tourniquet (T4). Results: There was no difference in IOP between the groups at T0 (P > 0.05), but it was higher at T2, T3, and T4 in Group CSE than in Group GA (P < 0.05). SAP was only higher in Group CSE at T3 (P < 0.05). İn Group GA IOP at T1, T3, and T4 was lower than that at T0 (P < 0.01) but were similar at T2 and T0 (P > 0.05). SAPs at T1, T3, and T4 were lower than those at T0 (P < 0.05) but were similar to those at T2 and T0 (P > 0.05). İn Group CSE although SAP was lower at T2, T3, and T4 than that at T0 (P < 0.05), IOP at T2 was higher than that at T0 (P < 0.01). IOP was the same at T3, T4, and T0 (P > 0.05). Abbreviations: IOP: intraocular pressure; CSEA: combined spinal-epidural anesthesia; SAP: systolic arterial pressure; DAP: diastolic arterial pressure; MAP: mean arterial pressure Key words: Intraocular Pressure; Anesthesia, Spinal; Anesthesia, General; Anesthesia, combined spinal-epidural; Tourniquet Citation: Yildiz G, Gulec H, Ozayar E, Horasanli E. Comparison of the effects of general anesthesia and combined spinal-epidural anesthesia on intraocular pressure in lower extremity surgeries employing pneumatic tourniquets: a randomized clinical trial. Anaesth. pain intensive care 2023;27(1):09−15 DOI: 10.35975/apic.v27i1.2135 Received: December 17, 2020; Reviewed: January 27, 2021; Accepted: March 18, 2021

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Section: Discussionmentioning

confidence: 98%

Comparison of the effects of general anesthesia and combined spinal-epidural anesthesia on intraocular pressure in lower extremity surgeries employing pneumatic tourniquets: a randomized clinical trial

Yildiz¹,

Güleç²,

Ozayar³

et al. 2023

Anaesth. pain intensive care

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The Effect of Labor on the Intraocular Pressure in Healthy Women

Meshi

Armarnik

Segev

et al. 2017

Journal of Glaucoma

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Intraocular Complications after Caudal Epidural Steroid Injection for Discogenic Lumbar Pain with Radiculopathy

Akhtar

Nazm

Keshkar³

et al. 2022

Journal of Orthopedics, Traumatology and Rehabilitation

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Background: Epidural steroid injection is a common intervention for symptomatic lumbar disc herniation. It is safe, but not absolutely free from complications. Visual complications and adverse intraocular events are sparse in the literature. This study is done to determine any intraocular complication after caudal epidural steroid injection for discogenic low back pain and radiculopathy. Materials and Methods: It was a prospective study, conducted from April 2018 to December 2019 by the orthopedics and ophthalmology departments of our institute. A total of 31 patients were recruited based on inclusion/exclusion criteria. All the patients presented to this institute with complaints of low back pain and sciatica were investigated. After proper diagnosis, the decision was made for caudal epidural steroid injection as per the standard principles of orthopedic surgery. Eye evaluations (intraocular pressure [IOP], visual acuity, and ocular examination) were done 1 day before, and 2–4 h, 1 week, and 2 weeks after epidural injection. The differences in eye evaluation values between time points were determined and discussed. Results: A total of 31 patients were recruited for this study, out of which the majority of the patients (27 patients) were between 41 and 60 years of age, and males (22 patients) outnumbered females (nine patients). Most of the patients (17 patients) had prolapsed IV disc of L5-S1. IOP was found to be raised after the intervention of epidural steroid injection which gradually came down to a preinjection level within 2 weeks. There was no change in visual acuity and no other intraocular complications, like hemorrhages. Conclusion: Epidural steroid injection for discogenic low backache (LBA) with radiculopathy did not adversely affect IOP, and neither had any ocular complication (in an ophthalmologically normal set of patients). A prudent approach should always be implemented.

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Short-term changes of intraocular pressure after cervical interlaminar epidural injection: a pilot study

Abstract: CEI resulted in an elevation of IOP of both eyes. However, the effects were transient only lasting a few minutes.

Cited by 3 publications

References 18 publications

Comparison of the effects of general anesthesia and combined spinal-epidural anesthesia on intraocular pressure in lower extremity surgeries employing pneumatic tourniquets: a randomized clinical trial

Comparison of the effects of general anesthesia and combined spinal-epidural anesthesia on intraocular pressure in lower extremity surgeries employing pneumatic tourniquets: a randomized clinical trial

The Effect of Labor on the Intraocular Pressure in Healthy Women

Intraocular Complications after Caudal Epidural Steroid Injection for Discogenic Lumbar Pain with Radiculopathy

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