Vision; Disorder, Loss
Conditions
Keywords
Desflurane, Near-infrared spectroscopy, Propofol, Spinal surgery, Prone position, Visual acuity, Visual loss
Brief summary
This study investigated the effect of desflurane and propofol anesthesia on visual acuity in patients in prone position for spinal surgery. Many trials have investigated the effects of different anesthetic agents on intraocular pressure, propofol may reduce intraocular pressure more than other intravenous anesthetics.
Detailed description
Perioperative increase in intraocular pressure can be caused by prone positioning. In addition to surgical factors, patients with glaucoma, uncontrolled hypertension, arthrosclerosis, and morbid obesity are at risk for potentially damaging optic nerve and loss of optic nerve function. Some studies found that intraocular pressure values were significantly lower in patients undergoing propofol total intravenous anesthesia than in patients undergoing desflurane anesthesia during intraoperative positional changes. Pronounced vasodilatation caused by desflurane might produced hyperaemia with higher intraocular pressure. Hemodynamic response to prone position measured by near-infrared spectroscopy (NIRS) on the prefrontal cortex could determine changes caused by prone position.
Interventions
PROCEDUREDesflurane Group
General anesthesia will be held using desflurane in end- tidal concentration according to target value of entropy levels (between 40 and 60).
PROCEDUREPropofol Group
General anesthesia will be held using Schnider effect model for propofol (target control anesthesia). Titration will be done according to target value of entropy levels (between 40 and 60).
Sponsors
University Hospital Hradec Kralove
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Glasgow Coma scale 15 * American Society of Anesthesiologists (ASA) Physical Status Classification System I-III * spinal surgery in duration less than 3 hours * sinus rhythm
Exclusion criteria
* postoperative artificial ventilation * serious neurological disease * lung disease with hypercapnia * propofol allergy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Visual injury | 48 hours | worsening of test for visual acuity (Rodenstock) |
Countries
Czechia
Contacts
Primary ContactVlasta Dostalova, MD, Ph.D.
Backup ContactPavel Dostal, MD, Ph.D.
Outcome results
None listed