Akademik Veri Yönetim Sistemi
Archives of the Balkan Medical Union, cilt.42, ss.149-152, 2007 (Scopus)
The aim of our study is to investigate the changes in intraocular pressure and its relationship with peak inspiratory pressure and patient positioning in chronic obstructive pulmonary disease patients during pneumoperitoneum. Sixteen patients with chronic obstructive pulmonary disease undergoing laparoscopic cholecystectomy were included in this study. Standart anaesthesia was performed and all patients were ventilated mechanically with a respiratory frequency of 12 min-1 and a tidal volume of 8 ml kg-1. Intraperitoneal insufflation of CO2 was maintained at the level of 12 mmHg. Mean arterial pressure, heart rate, intraocular pressure, peak inspiratory pressure and end tidal CO2 values were recorded six time points; Before the induction of anaesthesia, before pneumoperitoneum, in the horizontal position after the pneumoperitoneum, 15-degree Trendelenburg position, 15-degree Fowler position, and after desufflation. Intraocular pressure was 16.41±12 mmHg, 14.1±8.5 mmHg, 14.67±7.5 mmHg, 16.39±11 mmHg, 14.7±9.4 mmHg and 14.4±6.8 mmHg respectively. While peak inspiratory pressure and end tidal CO2 showed a continual increase with the establishment of pneumoperitoneum, an increase in intraocular pressure was associated only with the Trendelenburg position and never exceeded induction level. Haemodynamic measurements showed no clinically significant changes in this study. Although intraocular pressure is influenced minimally by the pneumoperitoneum, a special care should be taken with the Trendelenburg position. Copyright © 2007 Celsius.