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Masui. The Japanese journal of anesthesiology 11/2012; 61 Suppl:S112-9.
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ABSTRACT: Intraocular pressure (IOP) has been shown to increase during prone spine surgery. Although propofol and sevoflurane have been widely used during such surgery, there have been no data to compare the IOP changes under propofol and sevoflurane anesthesia. The present study was therefore conducted to investigate IOP changes under propofol and sevoflurane anesthesia during prone spine surgery.
After institutional approval and informed consent, 24 patients undergoing prone spine surgery were studied. Patients were randomly allocated to 1 of 2 groups: the propofol or sevoflurane group. Propofol or sevoflurane was administered to maintain the bispectral index between 40 and 60. The IOP was measured using a Tonopen XL hand-held tonometer 10 minutes after induction of anesthesia in the supine position (baseline), 10, 60, and 120 minutes after positioning in the prone position, and 10 minutes after returning to the supine position.
There were no significant differences in IOP values at baseline between the 2 groups. IOP values after positioning in the prone position were significantly higher than those at baseline in both groups (propofol group: from 8.9±3.5 to 21.9±5.0 mm Hg; sevoflurane group: from 11.6±3.9 to 24.8±3.4 mm Hg; P<0.05). Although IOP values were higher in the sevoflurane group than in the propofol group, the differences in IOP values were not statistically significant.
The results indicated that the choice of anesthetic agent, sevoflurane or propofol, did not have significant effects on IOP changes during a relatively short interval of prone spine surgery.
Journal of neurosurgical anesthesiology 04/2012; 24(2):152-6. · 2.41 Impact Factor
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ABSTRACT: Data on intraocular pressure (IOP) during cardiac surgery with cardiopulmonary bypass (CPB) and anesthetic management are limited. This study was conducted to investigate changes in IOP during cardiac surgery with and without CPB.
IOP was intraoperatively measured in patients undergoing elective cardiac surgery with (n = 35) or without (n = 11) CPB. Measurements were performed using a Tonopen(®) XL hand-held tonometer at the following five time points in patients with CPB: (1) 30 min after anesthesia induction (baseline), (2) prior to CPB, (3) 60 min after the beginning of CPB, (4) before cessation of CPB, and (5) at the end of operation; and in patients without CPB: (1) 30 min after anesthesia induction (baseline), (2) prior to anastomosis, (3) during left anterior descending artery anastomosis, (4) during left circumflex or right coronary artery anastomosis (head-down position), and (5) at the end of operation.
In patients with CPB, IOP values at points 3 and 4 were significantly decreased compared with baseline values and returned to baseline levels at point 5. In patients without CPB, values were significantly increased and peaked at point 4 in the head-down position compared with baseline and prior to anastomosis.
Results indicate that during cardiac surgery, IOP values decreased during CPB and increased during anastomosis in the head-down position in patients without CPB.
Journal of Anesthesia 10/2010; 24(5):663-8. · 0.83 Impact Factor
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ABSTRACT: A 76-year-old man underwent transurethral resection of bladder tumor under spinal anesthesia. Preoperative laboratory date showed normal platelet count (188,000 x microl(-1)) and normal coagulation profile (PT 11.4 sec, APTT 35.1 sec). Lumbar puncture was successfully performed at the L3-4 intervertebral space using a 27-gauge spinal needle with some technical difficulties. Nine hours after the operation, patient suddenly complained of pain from the buttocks to the thighs. Neither motor weakness nor sensory disturbance was found. Therefore conservative therapy was chosen with a diagnosis of transient neurologic symptoms (TNS). However, the subjective symptoms did improve. On the 6th postoperative day, magnetic resonance image (MRI) showed a large epidural hematoma from L1 to L4. On the 13th postoperative day, the subjective symptoms disappeared and MRI on the 17th postoperative day revealed the absence of the hematoma. We should keep in mind that epidural hematoma as well as TNS can occur after spinal anesthesia even with a very fine needle.
Masui. The Japanese journal of anesthesiology 05/2009; 58(4):456-9.
