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首页> 外文期刊>The Internet Journal of Anesthesiology >Correlation Of Intra-Operative Changes In Intraocular Pressures In Non-Ocular Surgeries With Post-Operative Nausea & Vomiting: A Comparative Study
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Correlation Of Intra-Operative Changes In Intraocular Pressures In Non-Ocular Surgeries With Post-Operative Nausea & Vomiting: A Comparative Study

机译：非眼外科手术中眼内压变化与术后恶心和呕吐的相关性：比较研究

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Introduction: Ocular surgeries and glaucoma can lead to nausea and vomiting due to raised intraocular pressure. Our present study is to evaluate the raised intraocular pressure during general anesthesia in non-ocular surgeries as a possible contributing factor for postoperative nausea and vomiting.Design: Prospective randomized controlled studySetting: Anesthesia department of a tertiary care university teaching hospitalMaterial and methods:60 patients of ASA grade-I undergoing surface surgeries were randomly divided equally into two groups. Group-I patients were intubated with vecuronium bromide (.1mg/kg) and group-II with succinylcholine (2mg/kg). Intraocular pressure (IOP) measurements were taken by Shiotz tonometer perioperatively at predefined intervals. In the post-operative period every episode of nausea, retching and vomiting was recorded for first 36 hours following the induction of anesthesia.Results: Age, sex & duration of anaesthesia between two groups were statistically insignificant (p>0.05). There was a fall in IOP in Gr.I and a rise in IOP in Gr.II from preinduction to pre-intubation. There was a considerable rise of IOP at intubation in both groups, but in Gr. II the rise was seen above pre-induction level. The incidence of PONV was statistically significant in female population in both groups but insignificant difference was found in total episodes of PONV at any of the time intervals studied between two groups.Discussion: IOP increases after induction with succinylcholine and further increases after intubation and extubation. IOP seldom crosses the baseline value after administration of vecuronium. The incidence of PONV and the number of the patients requiring antiemetic treatment recorded in both groups is statistically insignificant. The maximum episodes of PONV were within 6-12 hours and could be explained by wearing out of analgesia and sedation. Nausea and vomiting were negligible after 24 hours due to subsidence of precipitating factors.Conclusion: Transient rises in IOP caused by succinylcholine do not affect the incidence and distribution of PONV Introduction Post-operative nausea and vomiting (PONV} are one of the most common complications following general anesthesia. Ocular surgeries and glaucoma lead to episodes of nausea and vomiting, possibly related with raised intraocular pressure (IOP) and extraocular muscle tension. Fluctuations in intraocular pressure are also noted in non-ocular surgeries as an effect of depolarizing neuromuscular blockers on extraocular muscles resulting in increased resting tension with increase in twitch response 9. Many factors, both physiological and pharmacological, contribute to determine intraocular pressure during anesthesia including skill and experience of the anaesthetists. We have planned in our present study to evaluate the raised intraocular pressure during general anesthesia in non-ocular surgeries as a possible contributing factor for postoperative nausea and vomiting. Materials and methods In the present study, 60 patients of ASA grade-I undergoing surface surgeries like mastectomy, herniorrhaphy etc were randomly divided equally into two groups. Group-I comprised of patients intubated with vecuronium bromide (0.1mg/kg) and group-II comprised of patients intubated with succinylcholine (2mg/kg). Exclusion criteria were age more than 60 or less than 16 years, known ophthalmic disease, previous history of PONV and motion sickness or any co-existing systemic disease. All the patients received same anesthetic management i.e. 6 hours of fasting and premedication with tab.alprazolam 0.5mg day before and 2 hours before surgery. They were induced with fentanyl 2mcg/kg and propofol till loss of verbal contact. Facilitation of endotracheal intubation was done according to their groups and vecuronium was supplemented in both the groups to maintain surgical relaxation. Anesthesia was maintained with N2O (66%) in O2 and isoflurane (0.5-1.5%). Intraocular pressure (IOP
机译：简介：眼科手术和青光眼会因眼压升高而导致恶心和呕吐。本研究旨在评估非眼科手术中全麻时眼压升高可能是术后恶心和呕吐的可能因素。设计：前瞻性随机对照研究背景：三级大学教学医院麻醉科材料与方法：60例患者将进行表面手术的ASA I级患者随机分为两组。第一组患者接受了维库溴铵（0.1mg / kg）的插管，第二组患者接受了琥珀酰胆碱（2mg / kg）的插管。 Shiotz眼压计在围手术期以预定的时间间隔进行眼内压（IOP）测量。术后第36小时，在麻醉诱导后的36小时内记录每一次恶心，呕吐和呕吐。结果：两组之间的年龄，性别和麻醉持续时间均无统计学意义（p> 0.05）。从诱导前到插管前，Gr.I的IOP下降，Gr.II的IOP上升。两组患者在插管时的眼压都有显着提高，但在Gr组中。二是上升幅度超过预感应水平。两组女性人群中PONV的发生率在统计学上均具有统计学意义，但两组之间在任何时间间隔的PONV总发作中差异均无统计学意义。讨论：琥珀酰胆碱诱导后IOP升高，插管和拔管后IOP进一步升高。施用维库溴铵后，IOP很少会越过基线值。两组中记录的PONV的发生率和需要止吐治疗的患者人数在统计学上均无关紧要。 PONV的最大发作发生在6到12个小时之内，可以用镇痛剂和镇静剂来解释。结论：琥珀酰胆碱引起的眼压短暂升高并不影响PONV的发生和分布。引言术后恶心和呕吐（PONV）是最常见的并发症之一，在24小时后，恶心和呕吐可以忽略不计。全身麻醉后，眼外科手术和青光眼会导致恶心和呕吐，可能与眼内压升高（IOP）和眼外肌张力有关;在非眼科手术中，眼内压也会出现波动，这是由于神经肌肉阻滞剂对眼外肌导致静息张力增加，抽搐反应增强9.麻醉期间，包括生理和药理学在内的许多因素决定了眼压，包括麻醉师的技能和经验，我们计划在本研究中评估眼压的升高全身麻醉期间眼科手术可能是术后恶心和呕吐的可能因素。材料和方法在本研究中，将60例接受乳腺切除术，疝气治疗等表面手术的ASA I级患者随机分为两组。第一组包括经维库溴铵（0.1mg / kg）插管的患者，第二组包括经琥珀酰胆碱（2mg / kg）插管的患者。排除标准是年龄大于60岁或小于16岁，已知的眼科疾病，PONV的既往史和晕车病或任何并存的系统性疾病。所有患者均接受相同的麻醉处理，即在手术前一天和手术前2小时分别禁食和禁忌6小时，联合使用0.5mg的tab.alprazolam。用芬太尼2mcg / kg和丙泊酚诱导它们直至失去言语接触。根据他们的分组简化了气管插管，并在两组中补充了维库溴铵以维持手术松弛。用N2O（66％）的O2和异氟烷（0.5-1.5％）维持麻醉。眼压（IOP

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