Intraocular Pressure, Spinal Anesthesia, Surgical Positioning
Conditions
Keywords
Upper Extremity Position, Intraocular Pressure, Spinal Anesthesia, Surgical Positioning
Brief summary
This prospective randomized controlled trial evaluated the effect of two upper extremity positions on intraocular pressure (IOP) in adult patients undergoing surgery under spinal anesthesia. Participants were randomly assigned to either an arms-at-sides position or a hands-on-chest position. IOP was measured in the right eye using an Icare ic200 rebound tonometer at predefined perioperative time points. Hemodynamic parameters, including mean arterial pressure, heart rate, and oxygen saturation, were also recorded. The primary outcome was the change in IOP from baseline to 30 minutes between the two upper extremity position groups.
Detailed description
Intraocular pressure (IOP) may be influenced by systemic hemodynamics, venous return, episcleral venous pressure, and patient positioning. Although the effects of head and body position on IOP have been investigated, the impact of upper extremity positioning during spinal anesthesia has not been clearly established. This prospective randomized controlled trial was conducted at Elazig Fethi Sekin City Hospital. Adult patients scheduled for elective surgery under spinal anesthesia were enrolled. After written informed consent, participants were randomly assigned to one of two upper extremity positions: arms positioned alongside the body or hands positioned on the chest. IOP was measured in the right eye using an Icare ic200 rebound tonometer. Measurements were obtained at baseline, 15 minutes, and 30 minutes after spinal anesthesia and positioning. Head and neck position was maintained neutral throughout the measurement period. Hemodynamic parameters, including mean arterial pressure, heart rate, and peripheral oxygen saturation, were recorded simultaneously. The primary outcome was the change in IOP from baseline to 30 minutes between the two study groups. Secondary outcomes included IOP change at 15 minutes and perioperative hemodynamic changes.
Interventions
OTHERUpper Extremity Positioning
Participants were assigned to one of two upper extremity positions during spinal anesthesia: arms positioned alongside the body or hands positioned over the chest.
Sponsors
Elazıg Fethi Sekin Sehir Hastanesi
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
BASIC_SCIENCE
Masking
SINGLE (Outcomes Assessor)
Masking description
Due to the nature of the intervention, participants and care providers could not be blinded. However, intraocular pressure measurements were performed by an outcome assessor blinded to group allocation.
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Age between 18 and 80 years * ASA physical status I-III * Scheduled for elective open inguinal hernia repair under spinal anesthesia * Ability to undergo intraocular pressure measurement * Provision of written informed consent
Exclusion criteria
* History of glaucoma or ocular hypertension * Previous ocular surgery or ocular trauma * Active ocular disease or infection * Contraindication to spinal anesthesia * Inability to cooperate with intraocular pressure measurements * Refusal to participate
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Intraocular Pressure From Baseline to 30 Minutes | Baseline and 30 minutes after spinal anesthesia and upper extremity positioning | Intraocular pressure was measured in the right eye using an Icare ic200 rebound tonometer. The primary outcome was the change in intraocular pressure from baseline to 30 minutes after spinal anesthesia and upper extremity positioning between the two study groups. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Intraocular Pressure From Baseline to 15 Minutes | Baseline and 15 minutes after spinal anesthesia and upper extremity positioning | Intraocular pressure was measured in the right eye using an Icare ic200 rebound tonometer. This secondary outcome was the change in intraocular pressure from baseline to 15 minutes after spinal anesthesia and upper extremity positioning between the two study groups. |
| Mean Arterial Pressure | Baseline, 15 minutes, and 30 minutes after spinal anesthesia and upper extremity positioning | Mean arterial pressure was recorded simultaneously with intraocular pressure measurements and evaluated between the two study groups. |
Countries
Turkey (Türkiye)
Outcome results
None listed