Effects of desflurane and sevoflurane anesthesia on intraocular pressure in pediatric patients

Aim: One of the undesirable consequences of ophthalmic surgery is increase in intraocular pressure. Intraocular pressure can be greatly affected by surgical and anesthesia procedures. This study aimed to analyze the differences in intraocular pressure according to the anesthetics (sevoflurane or desflurane) administered during general anesthesia for strabismus surgery in healthy children.

Materials and Methods: This prospective study included 48 patients aged 6–15 years who were scheduled for one-eye strabismus surgery. Based on the agent, they were randomly assigned to the desflurane (n = 26) and sevoflurane (n = 22) groups. Intraocular pressure was measured in the contralateral eye. The hemodynamic parameters and intraocular pressure of all patients were assessed four times: before induction of anesthesia (Control), before intubation (up to 3 min) (T1), immediately after intubation (up to 1 min) (T2), and under deep anesthesia during mechanical ventilation (T3).

Results: In both desflurane and sevoflurane groups, intraocular pressure values fell considerably following anesthesia induction (T1) compared to control measures (p < 0.001 and p = 0.014, respectively). This reduction was more pronounced in the desflurane group than in the sevoflurane group (p = 0.008). A significant decrease in mean arterial pressure was observed only at the T3 time point in both groups compared to the control data. The decrease in mean arterial pressure at T3 was more significant in the sevoflurane group compared to the desflurane group (p = 0.015).

Conclusion: In pediatric ophthalmic surgery, the administration of desflurane and sevoflurane significantly decreased intraocular pressure levels during the induction phase compared to the awake state. Both anesthetic drugs are securely applicable in pediatric ophthalmic surgery due to their dependable anesthetic characteristics and their ability to reduce intraocular pressure.