■确定全身麻醉对无眼内病理的儿童眼内压(IOP)的影响,并确定哪个麻醉后时间点最能预测诱导前IOP。
■前瞻性观察性研究。
■未眼内病理≤18岁的儿童作为常规护理的一部分,由南京医科大学的儿科眼科医生指导。
■参与者接受了使用七氟醚和异丙酚维持的面罩诱导的标准化全身麻醉方案。在以下7个时间点测量眼内压:诱导前(在术前区域拍摄),诱导后第1、3和5分钟,以及诱导后第1、3和5分钟的总时间段为诱导后10分钟。使用广义估计方程来评估麻醉对IOP的影响以及患者因素的影响(年龄,性别,生命体征,和气道类型)在麻醉前和麻醉后IOP上。使用麻醉后IOP测量值开发了IOP预测模型,用于预测诱导前IOP。
■在预定时间点的眼压和眼压变化。
■招募了85名儿童,平均年龄为7.5±2.9岁。平均±SD诱导前IOP为20.1±3.7mmHg。总的来说,诱导后3分钟眼压最低,降低至平均13.4±3.7mmHg(P<0.001)。在这之后,眼压在诱导后5分钟上升至16.5±4.2mmHg,未达到诱导前眼压水平(P<0.001)。眼压预测模型显示,诱导后1分钟和气道后3分钟相结合是最具预测性的(R2=0.13),而1分钟后气道对诱导前IOP的预测最少(R2=0.01)。
■儿童全身麻醉诱导后,IOP在诱导后3分钟以波谷暂时降低,然后升高并保持稳定,仅低于诱导前水平。诱导后1分钟和气道放置后3分钟测量的眼压最能预测诱导前眼压。虽然预测值相对较低。
■专有或商业披露可在本文末尾的脚注和披露中找到。
UNASSIGNED: To determine the effect of general anesthesia on intraocular pressure (IOP) in children with no intraocular pathology and determine which postanesthetic time point is most predictive of preinduction IOP.
UNASSIGNED: Prospective observational study.
UNASSIGNED: Children with no intraocular pathology ≤ 18 years scheduled for general anesthesia as part of their routine care followed by a pediatric ophthalmologist at Nanjing Medical University.
UNASSIGNED: Participants underwent a standardized general anesthetic protocol using a mask induction with sevoflurane and propofol maintenance. Intraocular pressure was measured at the following 7 time points: preinduction (taken in the preoperative area), postinduction minutes 1, 3, and 5, and postairway placement minutes 1, 3, and 5 for a total time period of 10 minutes after induction. A generalized estimating equation was used to evaluate the effect of anesthesia on IOP and the effect of patient factors (age, gender, vital signs, and airway type) on preanesthetic and postanesthetic IOP. An IOP prediction model was developed using the postanesthesia IOP measurements for predicting preinduction IOP.
UNASSIGNED: Intraocular pressure and change in IOP at prespecified time points.
UNASSIGNED: Eighty-five children were enrolled with a mean ± standard deviation (SD) age of 7.5 ± 2.9 years. Mean ± SD preinduction IOP was 20.1 ± 3.7 mmHg. Overall, IOP was lowest at 3 minutes postinduction, decreased to a mean of 13.4 ± 3.7 mmHg (P < 0.001). After this, IOP rose 5 minutes postinduction to 16.5 ± 4.2 mmHg, which did not reach preinduction IOP levels (P < 0.001). The IOP prediction model showed that combining 1 minute postinduction and 3 minutes postairway was most predictive (R2 = 0.13), whereas 1 minute postairway was least predictive of preinduction IOP (R2 = 0.01).
UNASSIGNED: After the induction of general anesthesia in children, IOP temporarily decreases with a trough at 3 minutes postinduction before increasing and remaining stable just below preinduction levels. Intraocular pressure measurements taken 1 minute after induction with 3 minutes after airway placement are most predictive of preinduction IOP, though predictive value is relatively low.
UNASSIGNED: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.