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[Monitoring of blood pressure during phacotrabeculectomy]
Małgorzata Figurska1, Elzbieta Płocnarska, Andrzej Stankiewicz
1Kliniki Okulistyki Wojskowego Instytutu Medycznego w Warszawie.
Purpose:
To evaluate systolic and diastolic blood pressure during phacotrabeculectomy performed under regional anaesthesia with retrobulbar block and intravenous analgosedation with midazolam and fentanyl.
Material And Methods:
68 patients were involved into the study: I Group: 37 patients with chronic cardiovascular and metabolic diseases: 22 women and 15 men (45 operations), mean aged 72.02 years, mean weight 73.4 kg, II Group: 31 patients without additional diseases: 20 women and 11 men (44 operations), mean aged 70 years, mean weight 68.9 kg. Systolic and diastolic arterial blood pressure was recorded at 5-minute intervals throughout the intraoperative period and anesthetist intervened medically when necessary.
Results:
In I Group statistically significant mean systolic BP decrease was observed in 5 and 20 minutes after injection of midazolam and fentanyl and mean diastolic BP decrease was observed in 5 and 15 minutes after analgosedation. In II Group statistically significant mean systolic BP decrease was noted in 5 minutes and mean diastolic BP decrease in 5 and 35 minutes. During phacotrabeculectomy mean systolic and diastolic BP was statistically higher in I group. In I group 12 patients and in II group 4 patients required additional antihypertensive drug.
Conclusions:
Regional anaesthesia with retrobulbar block and intravenous analgosedation provides hemodynamic stability. Patients with cardiovascular and metabolic diseases required acute observation during phacotrabeculectomy.
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Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
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Pre-Procedural Guidelines for Doppler Ultrasound Blood Pressure Assessment:
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Measurement of Blood Pressure
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The Brachial Artery: Primary Site for Blood Pressure Measurement
