[Effects of an additional dose of propofol on intraocular pressure in patients over 60 years of age].
Changes in intraocular pressure (IOP) and mean arterial pressure (MAP) were studied in fifty patients, ASA 1 or 2, aged more than 60 years and scheduled for surgery of the anterior chamber of the eye. The exclusion criteria were: arterial hypertension, raised IOP, obesity, renal or hepatic disease, treatment likely to alter IOP, and a possibly difficult intubation. The patients were randomly assigned to groups P1 (n = 25) and P2 (n = 25). All were given lorazepam 1 mg orally 90 min before induction, which was carried out with propofol 1.5 mg.kg-1 and vecuronium 0.1 mg.kg-1. Patients in group P1 were intubated as soon as the train-of-four response (TOF) had been abolished. Those in group P2 were given an additional 0.7 mg.kg-1 dose of propofol before intubation. MAP, heart rate and IOP were measured before and after induction, and 1, 2 and 3 min after intubation. IOP decreased after induction, and remained below the baseline values at all times in both groups. MAP had a similar course in both groups up to 1 min after intubation: a decrease after induction followed by an increase after intubation. In group P1, MAP remained above control values 2 and 3 min after intubation, whereas in P2 it remained below. From this study, it can be concluded that using an additional dose of propofol in elderly patients was not useful for avoiding the rise in IOP due to endotracheal intubation. This was all the more so as the haemodynamic effects of such a dose of propofol could have deleterious effects in these patients.
Francon
D
D
Département d'Anesthésie-Réanimation, Groupe Hospitalier Adulte La Timone, Marseille.
Pellissier
D
D
Viviand
X
X
Paulo
F
F
François
G
G
D000367:Age Factors; D000368:Aged; D000768:Anesthesia, General / Q000379:methods; D001794:Blood Pressure / Q000187:drug effects; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D007442:Intubation, Intratracheal; D008297:Male; D015742:Propofol / Q000008:administration & dosage / Q000494:pharmacology*
D015742:Propofol
Effets d'une dose additionnelle de propofol sur la pression intraoculaire chez les sujets de plus de 60 ans.