Attenuation of increased intraocular pressure with propofol anesthesia: A systematic review with meta-analysis and trial sequential analysis
Attenuation of an increase in intraocular pressure (IOP) is crucial to preventing devastating postoperative visual loss following surgery. IOP is affected by several factors, including the physiologic alteration due to pneumoperitoneum and patient positioning and differences in anesthetic regimens....
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doaj-fbdecb501ed14159b76f956e69cea9f62020-11-25T03:16:54ZengElsevierJournal of Advanced Research2090-12322020-07-0124223238Attenuation of increased intraocular pressure with propofol anesthesia: A systematic review with meta-analysis and trial sequential analysisChun-Yu Chang0Yung-Jiun Chien1Meng-Yu Wu2School of Medicine, Tzu Chi University, Hualien 970, TaiwanDepartment of Physical Medicine and Rehabilitation, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 231, TaiwanDepartment of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 231, Taiwan; Department of Emergency Medicine, School of Medicine, Tzu Chi University, Hualien 970, Taiwan; Corresponding author at: Department of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 231, Taiwan.Attenuation of an increase in intraocular pressure (IOP) is crucial to preventing devastating postoperative visual loss following surgery. IOP is affected by several factors, including the physiologic alteration due to pneumoperitoneum and patient positioning and differences in anesthetic regimens. This study aimed to investigate the effects of propofol-based total intravenous anesthesia (TIVA) and volatile anesthesia on IOP. We searched multiple databases for relevant studies published before October 2019. Randomized controlled trials comparing the effects of propofol-based TIVA and volatile anesthesia on IOP during surgery were considered eligible for inclusion. Twenty studies comprising 980 patients were included. The mean IOP was significantly lower in the propofol-based TIVA group after intubation, pneumoperitoneum, Trendelenburg positioning, and lateral decubitus positioning. Moreover, mean arterial pressure and peak inspiratory pressure were also lower after intubation in the propofol-based TIVA group. Trial sequential analyses for these outcomes were conclusive. Propofol-based TIVA is more effective than volatile anesthesia during surgery at attenuating the elevation of IOP and should be considered, especially in at-risk patients.http://www.sciencedirect.com/science/article/pii/S2090123220300321AnesthesiaIntraocular pressureMeta-analysisPropofolTrial sequential analysis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Chun-Yu Chang Yung-Jiun Chien Meng-Yu Wu |
spellingShingle |
Chun-Yu Chang Yung-Jiun Chien Meng-Yu Wu Attenuation of increased intraocular pressure with propofol anesthesia: A systematic review with meta-analysis and trial sequential analysis Journal of Advanced Research Anesthesia Intraocular pressure Meta-analysis Propofol Trial sequential analysis |
author_facet |
Chun-Yu Chang Yung-Jiun Chien Meng-Yu Wu |
author_sort |
Chun-Yu Chang |
title |
Attenuation of increased intraocular pressure with propofol anesthesia: A systematic review with meta-analysis and trial sequential analysis |
title_short |
Attenuation of increased intraocular pressure with propofol anesthesia: A systematic review with meta-analysis and trial sequential analysis |
title_full |
Attenuation of increased intraocular pressure with propofol anesthesia: A systematic review with meta-analysis and trial sequential analysis |
title_fullStr |
Attenuation of increased intraocular pressure with propofol anesthesia: A systematic review with meta-analysis and trial sequential analysis |
title_full_unstemmed |
Attenuation of increased intraocular pressure with propofol anesthesia: A systematic review with meta-analysis and trial sequential analysis |
title_sort |
attenuation of increased intraocular pressure with propofol anesthesia: a systematic review with meta-analysis and trial sequential analysis |
publisher |
Elsevier |
series |
Journal of Advanced Research |
issn |
2090-1232 |
publishDate |
2020-07-01 |
description |
Attenuation of an increase in intraocular pressure (IOP) is crucial to preventing devastating postoperative visual loss following surgery. IOP is affected by several factors, including the physiologic alteration due to pneumoperitoneum and patient positioning and differences in anesthetic regimens. This study aimed to investigate the effects of propofol-based total intravenous anesthesia (TIVA) and volatile anesthesia on IOP. We searched multiple databases for relevant studies published before October 2019. Randomized controlled trials comparing the effects of propofol-based TIVA and volatile anesthesia on IOP during surgery were considered eligible for inclusion. Twenty studies comprising 980 patients were included. The mean IOP was significantly lower in the propofol-based TIVA group after intubation, pneumoperitoneum, Trendelenburg positioning, and lateral decubitus positioning. Moreover, mean arterial pressure and peak inspiratory pressure were also lower after intubation in the propofol-based TIVA group. Trial sequential analyses for these outcomes were conclusive. Propofol-based TIVA is more effective than volatile anesthesia during surgery at attenuating the elevation of IOP and should be considered, especially in at-risk patients. |
topic |
Anesthesia Intraocular pressure Meta-analysis Propofol Trial sequential analysis |
url |
http://www.sciencedirect.com/science/article/pii/S2090123220300321 |
work_keys_str_mv |
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