The Alteration of Intraocular Pressure and Ocular Pulse Amplitude by Retrobulbar Anaesthesia—A Search for Risk Factors for Serious Complications Due to Retrobulbar Anaesthesia
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Descriptive Statistics
3.1.1. Patient Cohort
3.1.2. Validity of the Measurements with the DCT
3.1.3. Change in IOP
3.1.4. Change in OPA
3.2. Factors Influencing IOP/OPA
3.2.1. IOP
3.2.2. OPA
4. Discussion
4.1. IOP
4.2. OPA
4.3. Limitations of the Study Structure
4.4. Summary
4.5. Notes by the Authors
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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VAT | Explanation |
---|---|
0 | No increased pressure from behind |
1 | Slightly increased pressure with pulsation of the iris-lens diaphragm |
2 | Increased pressure with pulsation of the iris up to the cornea |
3 | Significantly increased pressure with prolapse of intraocular tissue |
Parameters | Mean ± SD | Range from–to |
---|---|---|
Body height [cm], n = 132 | 168 ± 10 | 145–198 |
Weight [kg], n = 132 | 78 ± 16 | 45–140 |
BMI [kg/m2] n = 132 | 28 ± 5 | 17–56 |
MAP [mmHg] before midazolam, n = 127 | 91 ± 14 | 61–127 |
Heart rate [beats/min], n = 131 | 74 ± 15 | 48–118 |
Visual acuity after Snellen, n = 131 | 0.4 ± 0.3 | 0.0–1.0 |
SÄQ [Dpt], n = 126 | 1.0 ± 4.7 | −14.4–25.4 |
K [Dpt], n = 128 | 43.3 ± 1.3 | 39.3–46.7 |
Anterior chamber depth [mm], n = 123 | 3.2 ± 0.7 | 2.0–6.3 |
AL [mm], n = 129 | 23.4 ± 2.2 | 15.2–33.8 |
Time Point | Measurement | Q1–5 Mean ± SD [Minimum–Maximum] n | Q1–3 Mean ± SD [Minimum–Maximum] n |
---|---|---|---|
Before 1st RBA | IOP [mmHg] | 17.3 ± 7.7 [1.7–35.8] n = 133 | 18.9 ± 7.2 [2.9–35.8] n = 88 |
OPA [mmHg] | 4.2 ± 2.0 [1.2–10.7] n = 133 | 3.8 ± 1.7 [1.2–8.4] n = 88 | |
After 1st RBA | IOP [mmHg] | 15.8 ± 6.3 [0.3–29.7] n = 134 | 15.4 ± 6.3 [0.3–29.7] n = 101 |
OPA [mmHg] | 3.0 ± 2.0 [0.6–13.5] n = 133 | 3.0 ± 1.9 [0.6–13.5] n = 101 | |
After 2nd RBA | IOP [mmHg] | 17.6 ± 8.6 [3.3–38.8] n = 35 | 17.5 ± 8.5 [3.3–34.1] n = 24 |
OPA [mmHg] | 2.5 ± 1.7 [0.7–7.3] n = 35 | 2.6 ± 1.6 [0.8–7.3] n = 24 |
Before 1st RBA | Before 2nd RBA | After 2nd RBA | |
---|---|---|---|
IOP [mmHg] Q1–3 | 18.9 ± 7.2 [2.9–35.8] n = 88 | 15.4 ± 6.3 [0.3–29.7] n = 101 | 17.5 ± 8.5 [3.3–34.1] n = 24 |
Before 1st RBA | Before 2nd RBA | After 2nd RBA | |
---|---|---|---|
OPA [mmHg] Q1–3 | 3.8 ± 1.7 [1.2–8.4] n = 88 | 3.0 ± 1.9 [0.6–13.5] n = 101 | 2.6 ± 1.6 [0.8–7.3] n = 24 |
Influencing Factors | Difference IOP [mmHg] | Difference OPA [mmHg] | ||||
---|---|---|---|---|---|---|
Time Point (before/after 1st/2nd RBA) | ||||||
Time Point (before/after 1st/2nd RBA) | after 1st | before 1st/after 2nd | after 2nd | after 1st | before 1st/after 2nd | after 2nd |
IOP before 1st RBA | + | + | + | − | − | − |
IOP before 2nd RBA | ---------- | ------------- | − | -------------- | ------------ | − |
OPA before 1st RBA | − | + | + | + | + | + |
OPA before 2nd RBA | ---------- | ------------- | − | -------------- | ------------ | − |
Lens status | − | − | − | − | − | − |
Vitreous status | − | − | − | − | − | − |
Axial length [mm] | − | + | + | − | − | − |
Lid area [cm2] | − | − | − | − | − | − |
Eye volume [cm3] | − | + | − | − | − | − |
Orbital volume [cm3] | − | − | − | − | − | − |
Orbit/Eye | − | + | + | − | − | − |
Anterior chamber depth [mm] | − | − | + | − | − | − |
Glaucoma | − | ------------- | − | − | − | − |
Age [years] | − | − | − | − | − | − |
Hearth rate [beats/minute] | − | − | − | − | − | − |
Body mass index [kg/m2] | + | − | − | − | − | − |
Midazolam administration | + | + | − | − | − | − |
Midazolam dosage [mg] | + | − | − | − | − | − |
Mean arterial pressure before midazolam application [mmHg] | − | − | − | − | + | + |
Diabetes mellitus | − | − | − | + | − | − |
Relative change IOP | Relative change OPA | |||||
VAT 0–1 | − | + | − | − | − | − |
VAT 2–3 | − | ------------- | ------------ | − | ------------- | ------------- |
Included Parameters | R2 | Regression Coefficient B | p | 95% KI | n |
---|---|---|---|---|---|
Difference IOP before/after 1st RBA [mmHg] | |||||
IOP before 1st RBA [mmHg] | 0.3 | 0.5 | <0.001 | 0.3–0.6 | 64 |
Midazolam dosage [mg] | 0.4 | −3.8 | 0.02 | −6.8–−0.7 | 63 |
Difference IOP before 1st/after 2nd RBA [mmHg] | |||||
Axial length [mm] | 0.6 | 2.9 | 0.001 | 1.3–4.5 | 13 |
Difference IOP before/after 2nd RBA [mmHg] | |||||
IOP before 1st RBA [mmHg] | 0.6 | 1.0 | 0.001 | 0.5–1.4 | 11 |
Included Parameters | R2 | Regression Coefficient B | p | 95% KI | n |
---|---|---|---|---|---|
Difference OPA before/after 1st RBA [mmHg] | |||||
OPA before 1st RBA [mmHg] | 0.3 | 0.6 | <0.001 | 0.4–0.8 | 69 |
Diabetes mellitus | 0.4 | 0.7 | 0.0 | 0.0–1.4 | 68 |
Difference OPA before 1st/after 2nd RBA [mmHg] | |||||
OPA before 1st RBA [mmHg] | 0.5 | 0.8 | 0.0 | 0.3–1.4 | 13 |
Mean arterial pressure before midazolam [mmHg] | 0.6 | 0.1 | 0.0 | 0.0–0.1 | 12 |
Difference OPA before/after 2nd RBA [mmHg] | |||||
Mean arterial pressure before midazolam [mmHg] | 0.5 | 0.1 | 0.0 | 0.0–0.2 | 11 |
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Dobberstein, D.; Seitz, B.; Viestenz, A.; Viestenz, A. The Alteration of Intraocular Pressure and Ocular Pulse Amplitude by Retrobulbar Anaesthesia—A Search for Risk Factors for Serious Complications Due to Retrobulbar Anaesthesia. J. Clin. Med. 2024, 13, 5172. https://doi.org/10.3390/jcm13175172
Dobberstein D, Seitz B, Viestenz A, Viestenz A. The Alteration of Intraocular Pressure and Ocular Pulse Amplitude by Retrobulbar Anaesthesia—A Search for Risk Factors for Serious Complications Due to Retrobulbar Anaesthesia. Journal of Clinical Medicine. 2024; 13(17):5172. https://doi.org/10.3390/jcm13175172
Chicago/Turabian StyleDobberstein, Deborah, Berthold Seitz, Anja Viestenz, and Arne Viestenz. 2024. "The Alteration of Intraocular Pressure and Ocular Pulse Amplitude by Retrobulbar Anaesthesia—A Search for Risk Factors for Serious Complications Due to Retrobulbar Anaesthesia" Journal of Clinical Medicine 13, no. 17: 5172. https://doi.org/10.3390/jcm13175172