title: Intra-ocular pressure changes during gynaecological laparoscopy.
abstract: Laparoscopic surgery carried out under general anaesthesia is associated with physiological changes, which also determine changes in intra-ocular pressure. We measured intra-ocular pressure at each phase of gynaecological laparoscopy, carried out under propofol-alfentanil-isoflurane general anaesthesia, in young women of ASA 1 status, with no pre-existing eye disease. Measurements were made with a Perkins applanation tonometer. Mean arterial pressure and end-tidal CO2 tension were kept constant throughout the study. Intra-ocular pressure decreased significantly after induction of anaesthesia, remained unchanged after a pneumoperitoneum of up to an intraperitoneal pressure of 15 mmHg had been created, increased significantly with head down tilt, but did not increase significantly above pre-induction values. Adequate depth of anaesthesia compensated for the intra-ocular pressure increase caused by head down position. Plateau airway pressure, considered as reflecting intrathoracic pressure, increased with intraperitoneal pressure elevation. However, such changes did not correlate with intra-ocular pressure changes.
authors.affiliation: Hôpital Antoine-Béclère, Clamart, France.
authors.forename: C
authors.initials: C
authors.lastname: Lentschener
authors.forename: D
authors.initials: D
authors.lastname: Benhamou
authors.forename: F
authors.initials: F
authors.lastname: Niessen
authors.forename: F J
authors.initials: FJ
authors.lastname: Mercier
authors.forename: H
authors.initials: H
authors.lastname: Fernandez
mesh_terms: D000328:Adult; D000768:Anesthesia, General; D005260:Female; D005836:Genitalia, Female / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D010535:Laparoscopy; D016343:Monitoring, Intraoperative; D011028:Pneumoperitoneum, Artificial; D011187:Posture / Q000502:physiology