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Effect of interscalene block on intraocular pressure and ocular perfusion pressure

BACKGROUND: Interscalene block (ISB) is commonly associated with Horner’s syndrome due to spread of local anesthetic to the cervical sympathetic chain. Postganglionic neurons that originate from superior cervical ganglia form the sympathetic innervation of eye. Decrease in sympathetic tone may chang...

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Autores principales: Basaran, Betul, Yilbas, Aysun Ankay, Gultekin, Zeki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5651616/
https://www.ncbi.nlm.nih.gov/pubmed/29058613
http://dx.doi.org/10.1186/s12871-017-0436-x
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author Basaran, Betul
Yilbas, Aysun Ankay
Gultekin, Zeki
author_facet Basaran, Betul
Yilbas, Aysun Ankay
Gultekin, Zeki
author_sort Basaran, Betul
collection PubMed
description BACKGROUND: Interscalene block (ISB) is commonly associated with Horner’s syndrome due to spread of local anesthetic to the cervical sympathetic chain. Postganglionic neurons that originate from superior cervical ganglia form the sympathetic innervation of eye. Decrease in sympathetic tone may change intraocular pressure (IOP) and ocular perfusion pressure (OPP). The aim of the study was to investigate whether ISB affects IOP and/or OPP. METHODS: Thirty patients scheduled for ambulatory shoulder surgery under regional anesthesia with a single-shot ISB (15 mL 0.5% bupivacaine and 15 mL 2% lidocaine) were recruited. The IOP and OPP in both eyes, mean arterial pressure (MAP), heart rate (HR) and end-tidal CO(2) (ETCO(2)) were measured before ISB and 5, 10, 20, 30 and 60 min after ISB in the beach-chair position. RESULTS: The baseline IOP and OPP were similar in the blocked and unblocked sides (IOP 17.60 ± 1.69 and 17.40 ± 1.96 respectively p = 0.432; OPP 49.80 ± 8.20 and 50 ± 8.07 respectively p = 0.432). The IOP in the blocked side significantly decreased between 10th to 60th min following ISB, compared to the baseline values (p < 0.001). The OPP in the blocked side significantly increased from 10th to 60th min (p < 0.001) whereas, there were no significant changes in IOP and OPP throughout the measurement period in the unblocked side. CONCLUSIONS: ISB decreased IOP in the blocked side. ISB could be considered as a safe regional technique of choice in elderly patients at high risk for developing glaucoma.
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spelling pubmed-56516162017-10-26 Effect of interscalene block on intraocular pressure and ocular perfusion pressure Basaran, Betul Yilbas, Aysun Ankay Gultekin, Zeki BMC Anesthesiol Research Article BACKGROUND: Interscalene block (ISB) is commonly associated with Horner’s syndrome due to spread of local anesthetic to the cervical sympathetic chain. Postganglionic neurons that originate from superior cervical ganglia form the sympathetic innervation of eye. Decrease in sympathetic tone may change intraocular pressure (IOP) and ocular perfusion pressure (OPP). The aim of the study was to investigate whether ISB affects IOP and/or OPP. METHODS: Thirty patients scheduled for ambulatory shoulder surgery under regional anesthesia with a single-shot ISB (15 mL 0.5% bupivacaine and 15 mL 2% lidocaine) were recruited. The IOP and OPP in both eyes, mean arterial pressure (MAP), heart rate (HR) and end-tidal CO(2) (ETCO(2)) were measured before ISB and 5, 10, 20, 30 and 60 min after ISB in the beach-chair position. RESULTS: The baseline IOP and OPP were similar in the blocked and unblocked sides (IOP 17.60 ± 1.69 and 17.40 ± 1.96 respectively p = 0.432; OPP 49.80 ± 8.20 and 50 ± 8.07 respectively p = 0.432). The IOP in the blocked side significantly decreased between 10th to 60th min following ISB, compared to the baseline values (p < 0.001). The OPP in the blocked side significantly increased from 10th to 60th min (p < 0.001) whereas, there were no significant changes in IOP and OPP throughout the measurement period in the unblocked side. CONCLUSIONS: ISB decreased IOP in the blocked side. ISB could be considered as a safe regional technique of choice in elderly patients at high risk for developing glaucoma. BioMed Central 2017-10-23 /pmc/articles/PMC5651616/ /pubmed/29058613 http://dx.doi.org/10.1186/s12871-017-0436-x Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Basaran, Betul
Yilbas, Aysun Ankay
Gultekin, Zeki
Effect of interscalene block on intraocular pressure and ocular perfusion pressure
title Effect of interscalene block on intraocular pressure and ocular perfusion pressure
title_full Effect of interscalene block on intraocular pressure and ocular perfusion pressure
title_fullStr Effect of interscalene block on intraocular pressure and ocular perfusion pressure
title_full_unstemmed Effect of interscalene block on intraocular pressure and ocular perfusion pressure
title_short Effect of interscalene block on intraocular pressure and ocular perfusion pressure
title_sort effect of interscalene block on intraocular pressure and ocular perfusion pressure
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5651616/
https://www.ncbi.nlm.nih.gov/pubmed/29058613
http://dx.doi.org/10.1186/s12871-017-0436-x
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