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Sukhumal Thanapaisal, Julius Oatts, Jing Zhao, Claudio Ignacio Perez, Qian Liu, Travis C Porco, Ying Han; Effect of General Anesthesia on Intraocular Pressure in Pediatric Patients: A Meta-analysis. Invest. Ophthalmol. Vis. Sci. 2019;60(9):2407.
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The effect of general anesthesia agents on intraocular pressure in children is still controversial. We performed a meta-analysis to study the change in intraocular pressure (IOP) over time in children following general anesthesia (GA).
Pubmed, EMBASE, and CENTRAL databases were systematically searched following standard Cochrane guidelines to identify randomized controlled trials, prospective, and interventional studies. IOP, anesthesia time points and different agents during GA were recorded for non-glaucomatous pediatric patients (0-18 years old). The search included all studies through October 5th, 2018 with no date or language restrictions. Data of anesthetic agents use for induction and maintenance phase were extracted, together with IOP at different time points from prior to induction until deep anesthesia phase. Following data extraction, a linear mixed-effects regression analysis was performed.
The search strategy identified 519 studies. Six studies (520 eyes) were included for quantitative synthesis. Seven categories of mixed and non-mixed agents identified by induction and maintenance drugs were compared. By analysis of overall agent, the IOP decreased over time after induction phase at a rate of 0.62 ± 0.095 mmHg/min (mean ± standard error, P-value < 0.001). This is a model of mean IOP as a function of time and agent, weighted by the inverse of variance of each reported outcome and clustered on publications.
This meta-analysis showed that IOP decreases over time following induction of GA in children. Moreover, the model we developed helps ophthalmologists better understand and estimate changes in IOP during GA.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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