The effect of steep Trendelenburg positioning on intraocular pressure and visual function during robotic-assisted radical prostatectomy
| Autor: | Osamu Takahashi, Junko Koshimizu, Gautam A. Deshpande, Syuko Fujitani, Noriko Tsutsumi, Kentaro Tsuzuki, Kisiko Ohkoshi, Nariaki Echizen, Masafumi Hamada, Yuko Hoshikawa, Keiji Inagaki, Satoshi Serizawa |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty Intraocular pressure Supine position Visual acuity genetic structures medicine.medical_treatment Trendelenburg position Gonioscopy Visual Acuity Glaucoma Head-Down Tilt Cellular and Molecular Neuroscience Intraoperative Period Tonometry Ocular Ophthalmology medicine Humans Prospective Studies Intraocular Pressure Aged Prostatectomy medicine.diagnostic_test business.industry Perioperative Robotics Clinical Science Middle Aged medicine.disease Sensory Systems eye diseases Ophthalmoscopy Surgery Computer-Assisted Anesthesia sense organs medicine.symptom business Tomography Optical Coherence |
| Zdroj: | The British Journal of Ophthalmology |
| ISSN: | 1468-2079 0007-1161 |
| Popis: | Background To evaluate intraocular pressure (IOP) changes in patients undergoing robotic-assisted radical prostatectomy and to evaluate complications from increased IOP. Methods Thirty-one eyes scheduled for robotic prostatectomy were included. Perioperative IOP measurements were performed as follows: prior to induction of anaesthesia while supine and awake (T1); immediately post-induction while supine (T2); every hour from 0 to 5 h while anaesthetised in a steep Trendelenburg position (T3–T8); prior to awakening while supine (T9); and 30 min after awakening while supine (T10). A complete ophthalmic examination including visual acuity and retinal nerve fibre layer thickness (RNFL) was performed at enrolment and 1 month postoperatively. Results Average IOP (mm Hg) for each time point was as follows: T1=18.0, T2=9.8, T3=18.9, T4=21.6, T5=22.5, T6=22.3, T7=24.2, T8=24.0, T9=15.7 and T10=17.9. The proportion of eyes with intraoperative IOP ≧30 mm Hg were as follows: T3=0%, T4=3.23%, T5=9.68%, T6=6.45%, T7=22.22%, and T8=25%. Maximum IOP was 36 mm Hg. Mean visual acuity (logarithm of the minimal angle of resolution) and RNFL showed no statistically significant difference before and after operation and no other ocular complications were found at final examination. Conclusions While IOP increased in a time-dependent fashion in anesthaetised patients undergoing robotic-assisted radical prostatectomy in a steep Trendelenburg position, visual function showed no significant change postoperatively and no complications were seen. Steep Trendelenburg positioning during time-limited procedures appears to pose little or no risk from IOP increases in patients without pre-existing ocular disease. |
| Databáze: | OpenAIRE |
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