The effect of laryngeal mask airway insertion on intraocular pressure measurement in children receiving general anesthesia.
OBJECTIVE
To study changes in intraocular pressure (IOP) in children while under general anesthesia before and after laryngeal mask airway (LMA) insertion.


METHODS
Prospective, comparative study.


METHODS
IOP was measured in children after induction and one minute after LMA insertion. Children younger than 16 years who were scheduled to undergo elective ophthalmic surgery while receiving a general anesthetic were included. Children with a history of glaucoma or previous intraocular surgery were excluded. Data were collected on the age of the child, IOP, heart rate (HR), end tidal CO2, and blood pressure (BP) before and after LMA insertion.


RESULTS
Sixty-six children with a mean age of 5.5 +/- 3.6 years (range, four months to 16 years) were included in the study. The mean IOP was 13.6 +/- 3.9 mm Hg and 13.6 +/- 3.6 mm Hg in right and left eyes, respectively, before LMA insertion and 15.5 +/- 3.8 mm Hg and 15.2 +/- 3.8 mm Hg in right and left eyes, respectively, after LMA insertion (P = .001). A decrease in BP was significantly associated with an increase in IOP (P = .008), and the interaction between the change in the BP, HR, and CO2 affected the change in IOP measured after insertion of the LMA (P = .04). There was no correlation between the age of the child and the change in IOP measured after insertion of the LMA.


CONCLUSIONS
In our study, a small but significantly higher IOP was found after LMA insertion than before. It is recommended that the measurement of IOP in children receiving a general anesthetic is carried out before the insertion of the LMA.
Department of Ophthalmology, University Hospital of Wales, Cardiff, Wales, United Kingdom. Patrick.Watts@cardiffandvale.wales.nhs.uk
Patrick
P
Watts
May Kim
MK
Lim
Ravikiran
R
Gandhewar
Aychut
A
Mukherjee
Richard
R
Wintle
Trevor
T
Armstrong
Tahsin
T
Zatman
Rhys
R
Jones
Hasan
H
Al Madfai
D000293:Adolescent; D000768:Anesthesia, General; D001794:Blood Pressure; D002648:Child; D002675:Child, Preschool; D005260:Female; D006339:Heart Rate; D006801:Humans; D007223:Infant; D007429:Intraocular Pressure; D017214:Laryngeal Masks / Q000009:adverse effects*; D008297:Male; D009798:Ocular Hypertension / Q000175:diagnosis / Q000209:etiology*; D011446:Prospective Studies; D013990:Tidal Volume; D014065:Tonometry, Ocular