PROPOFOL DECREASES OCULAR PRESSURE IN OUTPATIENTS UNDERGOING TRABECULECTOMY

Study Objective: To examine the effect of a continuous low-dose intrav enous (IV) infusion of propofol on ocular pressure in outpatients unde rgoing trabeculectomy. Design: Randomized, prospective study. Setting: Teaching hospital. Patients: 40 unpremedicated outpatients with histo ry of primary open angle glaucoma undergoing trabeculectomy. Intervent ions: In the operating room an infusion of 5% dextrose into a peripher al vein was started. The propofol group (n = 20) received 0.5 mg/kg IV propofol bolus followed immediately by a continuous 0.5 mg/kg/hr infu sion. The control group (n = 20) received only the dextrose solution. A peribulbar block was performed with bupivacaine with added adrenalin e, plus lidocaine. The ocular pressure (tonometer) on the eye undergoi ng trabeculectomy and the other eye blood pressure (BP) and heart rate (HR) were measured at the following times: (1) preoperatively: (2) 2 minutes; (3) 5 minutes; (4) 10 minutes; (5) 15 minutes after propofol bolus administration for the propofol group (approximately 4 minutes a fter the peribulbar blockade on the eye undergoing surgery for the pro pofol and control groups). Measurements and Main Results: Ocular press ure decreased 2 minutes after propofol infusion (p < 0.0001) and remai ned significantly lower than in the control group throughout the study period. All patients remained awake and cooperative during all proced ures. Mean BP and HR were kept constant throughout the study. Conclusi on: Low-dose propofol sedation resulted in a decrease in ocular pressu re, was quick in onset, and was unrelated to BP and HR The decrease in ocular pressure may), be due to relaxation of extraocular muscles by propofol. (C) 1997 by Elsevier Science Inc.