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Abstract #19935 Published in IGR 9-4
The effect of laryngeal mask airway insertion on intraocular pressure measurement in children receiving general anesthesia
Watts P; Lim MK; Gandhewar R; Mukherjee A; Wintle R; Armstrong T; Zatman T; Jones R; Al Madfai HAmerican Journal of Ophthalmology 2007; 144: 507-510
PURPOSE: To study changes in intraocular pressure (IOP) in children while under general anesthesia before and after laryngeal mask airway (LMA) insertion. DESIGN: Prospective, comparative study. METHOD: 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 mmHg and 13.6 ± 3.6 mmHg in right and left eyes, respectively, before LMA insertion and 15.5 ± 3.8 mmHg and 15.2 ± 3.8 mmHg 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.
Dr. P. Watts, Department of Ophthalmology, University Hospital of Wales, Cardiff, Wales, UK. Patrick.Watts@cardiffandvale.wales.nhs.uk
Classification:
12.17 Anesthesia (Part of: 12 Surgical treatment)
6.1.3 Factors affecting IOP (Part of: 6 Clinical examination methods > 6.1 Intraocular pressure measurement; factors affecting IOP)