A comparative study of intraocular pressure and hemodynamic changes during general and regional anesthesia in abdominal and lower-limb surgeries

Abstract

Context: In general anesthesia, intubation/extubation and use of succinylcholine elevate intraocular pressure (IOP). Elevation of IOP during anesthesia may be detrimental to patients with preexisting ocular conditions such as glaucoma and uveitis. Regional anesthesia (spinal) lowers mean arterial and may lead to hemodynamic changes. Aims: We aimed to study changes in IOP and mean arterial pressure (MAP) in patients undergoing abdominal and lower-limb surgery following general and regional anesthesia. Setting and Design: A prospective comparative nonrandomized study was done. One hundred and twenty patients were randomly allocated to receive either general (Group A, n = 60) or regional anesthesia (Group B, n = 60), respectively. An independent investigator recorded MAP and IOP (Perkins handheld tonometer). Statistics: A one-way repeated measures analysis of variance (ANOVA) was done to determine whether there are any significant differences between the means of three or more levels of a within-subject factor (IOP and MAP) over time. Results: In Group A, there was a significant rise in IOP (ANOVA, P = 0.007) after general anesthesia over time. In Group B, the change in IOP (ANOVA, P = 0.219) was not statistically significant over time. However, there was a significant reduction in MAP over time. Between the groups, the mean change in IOP was significantly higher in patients in Group A and mean MAP significantly lower in Group B, respectively. Conclusion: Patients with glaucoma, uveitis, and cardiovascular diseases should have IOP monitoring prior to deciding the type of anesthesia and after anesthesia for lower-limb and abdominal surgeries. Sudden loss of vision after anesthesia needs immediate attention.

Keywords

• general anesthesia
• glaucoma
• intraocular pressure
• regional anesthesia