Intra-ocular pressure changes during gynaecological laparoscopy.
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.
Lentschener
C
C
Hôpital Antoine-Béclère, Clamart, France.
Benhamou
D
D
Niessen
F
F
Mercier
F J
FJ
Fernandez
H
H
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