Intraocular pressure changes after spinal anesthesia - acute and subacute effects on surgery patients

Abstract

Background. Spinal anesthesia has become appropriate for many surgical procedures. Neuraxial anesthesia can result in acute and late complications like hypotension, bradycardia, local anesthetic toxicity, postdural-puncture headache, backache and spinal nerve damage. Although the body's physiological responses to spinal anesthesia are well understood, its effects on intraocular pressure (IOP) haven't been mentioned before.

Objectives. The aim of this study was to investigate the effects of spinal anesthesia on IOP.

Material and Methods. Forty patients receiving spinal anesthesia for subumblical surgery were recruited for the study, after ethics committee approval and patients' written informed consent. IOP was measured by Icare PRO tonometer (Icare, Finland) before spinal anesthesia (BS), immediately after spinal anesthesia (AS) and finally on the first postoperative day (PO1). Both eyes of the patients were included in the study.

Results. Thirty-eight patients completed the study. Mean BS, AS and PO1 intraocular pressures were 16.53 +/- 3.17 (9.40-24.00), 17.08 +/- 3.16 (10.00-24.00) and 16.76 +/- 2.80 (10.20-23.00) mm Hg, respectively. Mean IOP measurements were not statistically different among the three groups (p = 0.104).

Conclusions. Spinal anesthesia alone has no acute or subacute effects on IOP. Studies can be made to evaluate the chronic effects. Further studies must be focused on the relationship between postdural puncture headache and intraocular pressure changes after spinal anesthesia