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- Title
The effect of acetazolamide on intra-ocular pressure after Trendelenburg positioning - a randomised double-blind crossover trial in volunteers.
- Authors
Vitish‐Sharma, P.; King, A. J.; Abbas, A.; Maxwell‐Armstrong, C.; Guo, B.; Acheson, A. G.; Vitish-Sharma, P; Maxwell-Armstrong, C
- Abstract
Recent evidence suggests Trendelenburg positioning can produce a significant rise in intra-ocular pressure. Peri-operative vision loss in patients undergoing laparoscopic colorectal surgery has been reported with the rise in intra-ocular pressure suggested as a possible factor. Acetazolamide decreases intra-ocular pressure by reducing the formation of aqueous humour, so we aimed to investigate if it could attenuate the intra-ocular pressure rise that can occur in the Trendelenburg position. Nine healthy volunteers were recruited and randomly assigned to a double-blind crossover comparison of placebo or acetazolamide with a minimal 4 days' washout period before the second study day. One and a half hours after taking the medication, volunteers lay head-down at 17° for 4 h. Intraocular pressure measurements were repeated in both eyes every 30 min over a 4-h period. There were two males and seven female volunteers, with a mean (SD) age of 54.3 (18.5) years. The mean (SD) increase in intra-ocular pressure following 4 h in the Trendelenburg position was 3.17 (4.63) mmHg after the placebo, and 0.02 (4.01) mmHg (p = 0.02) after acetazolamide. We have shown than acetazolamide can attenuate the rise that occurs in intra-ocular pressure when in the Trendelenburg position.
- Subjects
INTRAOCULAR pressure; ACETAZOLAMIDE; POSITIONING in surgery; LAPAROSCOPIC surgery; PROCTOLOGY; PERIOPERATIVE care; AQUEOUS humor; GLAUCOMA; PATIENTS; THERAPEUTICS; COMPARATIVE studies; CROSSOVER trials; DIURETICS; RESEARCH methodology; MEDICAL cooperation; REFERENCE values; RESEARCH; EVALUATION research; RANDOMIZED controlled trials; HUMAN research subjects; BLIND experiment; HEAD-down tilt position; PHARMACODYNAMICS
- Publication
Anaesthesia, 2017, Vol 72, Issue 12, p1523
- ISSN
0003-2409
- Publication type
journal article
- DOI
10.1111/anae.14017