Intraocular pressures in children during isoflurane and halothane anesthesia
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Isoflurane and halothane anesthesia do not significantly alter intraocular pressure (IOP) in cooperative pediatric patients. IOP remained stable compared to baseline in sedated children, regardless of ventilation method.
Area of Science:
- Anesthesiology
- Ophthalmology
- Pediatric Medicine
Background:
- Intraocular pressure (IOP) is a critical factor in ophthalmic health.
- Understanding anesthetic effects on IOP in children is essential for patient safety.
Purpose of the Study:
- To investigate the impact of isoflurane and halothane on intraocular pressure in pediatric patients.
- To compare IOP during spontaneous versus controlled ventilation under different anesthetic agents.
Main Methods:
- Studied 28 children undergoing anesthesia with isoflurane or halothane.
- Measured intraocular pressure (IOP) during spontaneous and controlled ventilation.
- Assessed effects of varying PaCO2 levels and compared to pre-anesthetic control values.
Main Results:
- Mean IOP during anesthesia ranged from 16.3 to 17.6 torr, not significantly different from controls in cooperative patients.
- Only uncooperative patients receiving chloral hydrate showed a significant IOP decrease.
- Hypocarbia and hypercarbia (PaCO2 > 42 torr) had minimal influence on IOP.
Conclusions:
- Isoflurane and halothane anesthesia do not significantly affect IOP in sedated, cooperative pediatric patients.
- Anesthetic choice and ventilation strategy appear to have minimal impact on IOP in this population.
- Findings suggest comparable IOP profiles between these anesthetics and pre-anesthetic sedation.
Abstract:
The effects of isoflurane and halothane on intraocular pressure (IOP) were studied in 28 children. Measurements were made during spontaneous ventilation and at a various levels of reduced PaCO2 achieved by controlled ventilation. Control IOP values were determined prior to anesthesia following premedication with chloral hydrate, pentobarbital, pentobarbital with meperidine. At roughly equivalent levels of anesthesia, mean IOP values during spontaneous ventilation ranged frm 16.3 to 17.6 torr for each anesthetic. These values were significantly less (P less than 0.01) than control values only in those patients receiving chloral hydrate who did not cooperate. In contrast, no significant change in IOP was found in more sedated and cooperative patients who received pentobarbital and meperidine. Moderate hypocarbia and hypercarbia over a range of PaCO2 greater than 42 torr had little influence on IOP. We conclude that IOP's during isoflurane and halothane anesthesia do not differ significantly from IOP in the sedated, cooperative, healthy pediatric patient.