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The effect of acetazolamide on intra‐ocular pressure after Trendelenburg positioning – a randomised double‐blind crossover trial in volunteers
Author(s) -
VitishSharma P.,
King A. J.,
Abbas A.,
MaxwellArmstrong C.,
Guo B.,
Acheson A. G.
Publication year - 2017
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/anae.14017
Subject(s) - medicine , acetazolamide , crossover study , anesthesia , trendelenburg position , trendelenburg , double blind , crossover , placebo , alternative medicine , pathology , artificial intelligence , computer science
Summary 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.