The effect of anesthetic agents on intraocular pressure during laparoscopic gynecological surgery performed in the Trendelenburg position: A randomized clinical trial

Genç Moralar, Döndü; saygı emir, nalan; Balkan, Bedih; Tontu, Furkan; demirayak, bengi; yektaş, abdulkadir

doi:10.14744/tjtes.2020.56019

The effect of anesthetic agents on intraocular pressure during laparoscopic gynecological surgery performed in the Trendelenburg position: A randomized clinical trial

Bedih BALKAN, (Sağlık Bilimleri Üniversitesi, Anesteziyoloji ve Reanimasyon Kliniği, Bakırköy Dr. Sadi Konuk Eğitim ve Araştırma Hastanesi, İstanbul, Türkiye)

Furkan TONTU, (Sağlık Bilimleri Üniversitesi, Anesteziyoloji ve Reanimasyon Kliniği, Bakırköy Dr. Sadi Konuk Eğitim ve Araştırma Hastanesi, İstanbul, Türkiye)

Döndü GENÇ MORALAR, (Sağlık Bilimleri Üniversitesi, Anesteziyoloji ve Reanimasyon Kliniği, Bakırköy Dr. Sadi Konuk Eğitim ve Araştırma Hastanesi, İstanbul, Türkiye)

Bengi DEMİRAYAK, (Sağlık Bilimleri Üniversitesi, Bakırköy Dr. Sadi Konuk Eğitim ve Araştırma Hastanesi, Göz Hastalıkları Anabilim Dalı, İstanbul, Türkiye)

Nalan SAYGI EMİR, (Sağlık Bilimleri Üniversitesi, Anesteziyoloji ve Reanimasyon Kliniği, Bakırköy Dr. Sadi Konuk Eğitim ve Araştırma Hastanesi, İstanbul, Türkiye)

Abdulkadir YEKTAŞ (Sağlık Bilimleri Üniversitesi, Diyarbakır Gazi Yaşargil Eğitim ve Araştırma Hastanesi, Anesteziyoloji ve Reanimasyon Kliniği, Diyarbakır, Türkiye)

Ulusal Travma ve Acil Cerrahi Dergisi

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Yıl: 2022 Cilt: 28 Sayı: 4 Sayfa Aralığı: 498 - 507 Metin Dili: İngilizce DOI: 10.14744/tjtes.2020.56019 İndeks Tarihi: 10-05-2023

The effect of anesthetic agents on intraocular pressure during laparoscopic gynecological surgery performed in the Trendelenburg position: A randomized clinical trial

Öz:

BACKGROUND: Intraocular pressure (IOP) increases due to pneumoperitoneum and the Trendelenburg position during laparoscopic surgery. Apart from ketamine and suxamethonium, anesthetic agents generally reduce IOP by various extents. The present study investigated the effects of combinations of four anesthetic agents on IOP during laparoscopic gynecological surgery. METHODS: Patients (n=100) were assigned to one of the four groups: Group 1 (n=25; pentothal induction + desflurane/remifentanil maintenance), Group 2 (n=25; propofol induction + sevoflurane/remifentanil maintenance), Group 3 (n=25; propofol induction + desflurane/remifentanil maintenance), and Group 4 (n=25; pentothal induction + sevoflurane/remifentanil maintenance). The IOPs recorded before anesthesia induction, after intubation, after carbon dioxide insufflation, in the Trendelenburg position, and after extubation were compared among the groups. Hemodynamic parameters were also evaluated. RESULTS: Induction in Group 2 and Group 3 used propofol. When the IOP in the Trendelenburg position was compared with the IOP before induction, there was no statistically significant difference in Groups 2 and 3 (p>0.05). In Groups 1 and 4, pentothal was used for induction. The IOP in Groups 1 and 4 was statistically significantly higher in the Trendelenburg position than it was before induction (0.027–0.001). CONCLUSION: To minimize the variation in IOP in the Trendelenburg position during laparoscopic gynecological surgeries, we recommend the use of propofol for induction, independent of desflurane or sevoflurane use.

Anahtar Kelime:

Trendelenburg pozisyonda yapılan laparoskopik jinekolojik cerrahi esnasında göz içi basıncı üzerine anestezik ajanların etkisi: Randomize klinik çalışma

Öz:

AMAÇ: Laparoskopik cerrahi sırasında pnömoperitoneum ve Trendelenburg pozisyonuna bağlı göz içi basıncı (GİB) artar. Ketamin ve süksametonyum dışında, anestezik ajanlar genellikle GİB’yi çeşitli oranlarda azaltır. Bu çalışmada, laparoskopik jinekolojik cerrahi sırasında dört anestezik ajan kombinasyonunun GİB üzerindeki etkileri araştırıldı. GEREÇ VE YÖNTEM: Hastalar (n=100) dört gruptan birine ayrıldı: grup 1 (n=25; pentotal indüksiyon + desfluran/remifentanil idame), grup 2 (n=25; propofol indüksiyon + sevofluran/remifentanil idame), grup 3 (n=25; propofol indüksiyonu + desfluran/remifentanil idamesi) ve grup 4 (n=25; pentotal indüksiyon + sevofluran/remifentanil idamesi). Anestezi indüksiyonu öncesi, entübasyon sonrası, karbondioksit üfleme sonrası, Trendelenburg pozisyonunda ve ekstübasyon sonrası kaydedilen GİB’ler gruplar arasında karşılaştırıldı. Hemodinamik parametreler de değerlendirildi. BULGULAR: Grup 2 ve grup 3’te indüksiyon propofol kullandı. Trendelenburg pozisyonundaki GİB ile indüksiyon öncesi GİB karşılaştırıldığında, 2. ve 3. gruplarda istatistiksel olarak anlamlı bir fark yoktu (p>0.05). Grup 1 ve 4’te indüksiyon için pentotal kullanıldı. Grup 1 ve 4’teki GİB, Trendelenburg pozisyonunda indüksiyon öncesine göre istatistiksel olarak anlamlı şekilde daha yüksekti (0.027–0.001). TARTIŞMA: Laparoskopik jinekolojik ameliyatlar sırasında Trendelenburg pozisyonundaki GİB’deki varyasyonu en aza indirmek için, desfluran veya sevofluran kullanımından bağımsız olarak indüksiyon için propofol kullanılmasını öneriyoruz.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	Balkan B, Tontu F, Genç Moralar D, demirayak b, saygı emir n, yektaş a (2022). The effect of anesthetic agents on intraocular pressure during laparoscopic gynecological surgery performed in the Trendelenburg position: A randomized clinical trial. , 498 - 507. 10.14744/tjtes.2020.56019
Chicago	Balkan Bedih,Tontu Furkan,Genç Moralar Döndü,demirayak bengi,saygı emir nalan,yektaş abdulkadir The effect of anesthetic agents on intraocular pressure during laparoscopic gynecological surgery performed in the Trendelenburg position: A randomized clinical trial. (2022): 498 - 507. 10.14744/tjtes.2020.56019
MLA	Balkan Bedih,Tontu Furkan,Genç Moralar Döndü,demirayak bengi,saygı emir nalan,yektaş abdulkadir The effect of anesthetic agents on intraocular pressure during laparoscopic gynecological surgery performed in the Trendelenburg position: A randomized clinical trial. , 2022, ss.498 - 507. 10.14744/tjtes.2020.56019
AMA	Balkan B,Tontu F,Genç Moralar D,demirayak b,saygı emir n,yektaş a The effect of anesthetic agents on intraocular pressure during laparoscopic gynecological surgery performed in the Trendelenburg position: A randomized clinical trial. . 2022; 498 - 507. 10.14744/tjtes.2020.56019
Vancouver	Balkan B,Tontu F,Genç Moralar D,demirayak b,saygı emir n,yektaş a The effect of anesthetic agents on intraocular pressure during laparoscopic gynecological surgery performed in the Trendelenburg position: A randomized clinical trial. . 2022; 498 - 507. 10.14744/tjtes.2020.56019
IEEE	Balkan B,Tontu F,Genç Moralar D,demirayak b,saygı emir n,yektaş a "The effect of anesthetic agents on intraocular pressure during laparoscopic gynecological surgery performed in the Trendelenburg position: A randomized clinical trial." , ss.498 - 507, 2022. 10.14744/tjtes.2020.56019
ISNAD	Balkan, Bedih vd. "The effect of anesthetic agents on intraocular pressure during laparoscopic gynecological surgery performed in the Trendelenburg position: A randomized clinical trial". (2022), 498-507. https://doi.org/10.14744/tjtes.2020.56019

APA	Balkan B, Tontu F, Genç Moralar D, demirayak b, saygı emir n, yektaş a (2022). The effect of anesthetic agents on intraocular pressure during laparoscopic gynecological surgery performed in the Trendelenburg position: A randomized clinical trial. Ulusal Travma ve Acil Cerrahi Dergisi, 28(4), 498 - 507. 10.14744/tjtes.2020.56019
Chicago	Balkan Bedih,Tontu Furkan,Genç Moralar Döndü,demirayak bengi,saygı emir nalan,yektaş abdulkadir The effect of anesthetic agents on intraocular pressure during laparoscopic gynecological surgery performed in the Trendelenburg position: A randomized clinical trial. Ulusal Travma ve Acil Cerrahi Dergisi 28, no.4 (2022): 498 - 507. 10.14744/tjtes.2020.56019
MLA	Balkan Bedih,Tontu Furkan,Genç Moralar Döndü,demirayak bengi,saygı emir nalan,yektaş abdulkadir The effect of anesthetic agents on intraocular pressure during laparoscopic gynecological surgery performed in the Trendelenburg position: A randomized clinical trial. Ulusal Travma ve Acil Cerrahi Dergisi, vol.28, no.4, 2022, ss.498 - 507. 10.14744/tjtes.2020.56019
AMA	Balkan B,Tontu F,Genç Moralar D,demirayak b,saygı emir n,yektaş a The effect of anesthetic agents on intraocular pressure during laparoscopic gynecological surgery performed in the Trendelenburg position: A randomized clinical trial. Ulusal Travma ve Acil Cerrahi Dergisi. 2022; 28(4): 498 - 507. 10.14744/tjtes.2020.56019
Vancouver	Balkan B,Tontu F,Genç Moralar D,demirayak b,saygı emir n,yektaş a The effect of anesthetic agents on intraocular pressure during laparoscopic gynecological surgery performed in the Trendelenburg position: A randomized clinical trial. Ulusal Travma ve Acil Cerrahi Dergisi. 2022; 28(4): 498 - 507. 10.14744/tjtes.2020.56019
IEEE	Balkan B,Tontu F,Genç Moralar D,demirayak b,saygı emir n,yektaş a "The effect of anesthetic agents on intraocular pressure during laparoscopic gynecological surgery performed in the Trendelenburg position: A randomized clinical trial." Ulusal Travma ve Acil Cerrahi Dergisi, 28, ss.498 - 507, 2022. 10.14744/tjtes.2020.56019
ISNAD	Balkan, Bedih vd. "The effect of anesthetic agents on intraocular pressure during laparoscopic gynecological surgery performed in the Trendelenburg position: A randomized clinical trial". Ulusal Travma ve Acil Cerrahi Dergisi 28/4 (2022), 498-507. https://doi.org/10.14744/tjtes.2020.56019