Muharrem EROL, Hanifi EROL, Gültekin ATALAN, Cengiz CEYLAN, MUHAMMED KAAN YÖNEZ

The Effects of Propofol-Sevoflurane, Midazolam-Sevoflurane and Medetomidine-Ketamine-Sevoflurane Anesthetic Combinations on Intraocular Pressure in Rabbits

Intraocular pressure (IOP) is dependent on equilibrium between the rate of formation and outflow humor aqueous in the eye. Determination of IOP is one of the most important points and a very useful parameter in ophthalmic surgery. The aim of this study was to compare the effects of propofol + sevoflurane, midazolam + sevoflurane, medetomidine + ketamine + sevoflurane anesthetic combinations on IOP, and to find out suitable anesthesia protocol in rabbits for ophthalmic surgery. For this purpose, a total of 40 healthy four months old New Zealand female rabbits (Mean weight 2.34±0.67 kg) were used as subjects. The animals were divided into four groups; propofol + sevoflurane (PS), midazolam + sevoflurane (MS), medetomidine + ketamine + sevoflurane (MKS), and control (C), each having 10 rabbits. The IOP was measured from the right eyes before injection of anesthetics (0. min), during sevoflurane anesthesia at 5th, 10th, 15th, 20th, 25th and 30th min, and post anesthesia at 10th, 20th, 30th, 60th, 120th min and 24 h in the study groups. In PS group; IOP values decreased during anesthesia between 5th and 25th min. In general, the measured IOP values of MS group were higher than 0th min, and the increases continued at 10th min in post anesthesia. The measured IOP values of MKS group during anesthesia were higher than other time points. As a result of this study PS anesthetic combination is an ideal anesthesia for ocular surgery in rabbits. The increase in IOP is undesirable in ocular surgery due to operative and postoperative complications. It was also concluded that investigating the effects of anesthetic combination on IOP should continue in more detailed researches including in different species.

Tavşanlarda Propofol-Sevofluran, Midazolam-Sevofluran ve Medetomidin-Ketamin-Sevofluran Anestezi Kombinasyonlarının Göz İçi Basıncına Etkileri

Göz içi basıncı (GİB), humor aközün dengeli bir şekilde üretimi ve drenajına bağlı olarak şekillenmektedir. GİB, oftalmik cerrahide önemli ve yararlı parametreler arasında yer almaktadır. Bu çalışmanın amacı tavşanlarda propofol + sevofluran, midazolam + sevofluran ve medetomidine + ketamin + sevofluran anestezi kombinasyonlarının GİB üzerine etkilerinin karşılaştırılması, oftalmik cerrahi için optimal anestezi protokolünün araştırılmasıdır. Çalışmada 40 adet 4 aylık sağlıklı dişi (ortalama ağırlık 2.34±0.67 kg) Yeni Zelanda tavşanı kullanıldı. Hayvanlar; propofol + sevofluran (PS), midazolam + sevofluran (MS), medetomidine + ketamin + sevofluran (MKS) ve kontrol (K) grubu şeklinde her bir grupta 10 adet tavşan olmak üzere toplam dört gruba ayrıldı. GİB ölçümleri çalışma gruplarında sağ gözden anestezi öncesi (0. dk), sevofluran anestezisi boyunca 5, 10, 15, 20, 25 ve 30. dakikalarda ve anestezi sonrası 10, 20, 30, 60, 120. dakikalarda ve 24 saat sonra yapıldı. PS grubunda anestezi süresi boyunca 5 ve 25. dk’lar arasında GİB değerlerinde azalma görüldü. Genel olarak MS grubunun ölçülen GİB değerlerinin 0. dk’dan yüksek seyrettiği ve anestezi sonrası 10. dk’ya kadar artışın devam ettiği görüldü. MKS grubunun anestezi sırasında ölçülen GİB değerinin anestezi öncesi ve sonrası değerlerden yüksek olduğu tespit edildi. Bu çalışma sonunda PS kombinasyonunun göz cerrahisi için daha uygun bir anestezi kombinasyonu olduğu görüldü. Oküler cerrahide GİB değerinin artışı operatif ve postoperatif olarak istenmeyen bir durumdur. Özellikle GİB üzerine anestezi kombinasyonlarının etkileri daha ayrıntılı ve türlere özel olarak araştırılması gerekmektedir.

PDF

___

1. Hazra S, Palui H, Biswas B, Konar A: Anesthesia for intraocular surgery in rabbits. Scand J Lab Anim Sci, 38 (2): 81-87, 2011. DOI: 10.23675/sjlas. v38i2.230

2. Erol M, Erol H, Atalan G, Doğan Z, Yönez MK, Melek S: Effects of systemically used midazolam, ketamine and isoflurane anaesthetic agents on intraocular pressure and tear production in rabbits. Harran Univ Vet Fak Derg, 7 (1): 21-25, 2018. DOI: 10.31196/huvfd.458783

3. Qui Y, Yang H, Lei B: Effects of three commonly used anesthetics on intraocular pressure in mouse. Curr Eye Res, 39 (4): 365-369, 2014. DOI: 10.3109/02713683.2013.845224

4. Ghaffari MS, Rezaei MA, Mirani AH, Khorami N: The Effects of ketamine-midazolam anesthesia on intraocular pressure in clinically normal dogs. Vet Ophthalmol, 13 (2): 91-93, 2010. DOI: 10.1111/j.14635224.2010.00762.x

5. Dogan E, Yanmaz LE, Ersoz U, Senocak MG, Okumus Z: The effect of different doses of intramuscular xylazine HCl administration on intraocular pressure in rabbits. Kafkas Univ Vet Fak Derg, 22 (5): 801-803, 2016. DOI: 10.9775/kvfd.2016.15222

6. Dogan E, Yanmaz LE, Senocak MG, Okumus Z: Comparasion of propofol, ketamine and ketofol on intraocular pressure in New Zealand white rabbits. Rev Med Vet, 167 (1-2): 18-21, 2016.

7. Kovalcuka L, Ilgazs A, Bandere D, Williams DL: Changes in intraocular pressure and horizontal pupil diameter during use of topical mydriatics in the canine eye. Open Vet J, 7 (1): 16-22, 2017. DOI: 10.4314/ovj.v7i1.3

8. Verbruggen AMJ, Akkerdaas LC, Hellebrekers LJ, States FC: The effect of intravenous medetomidine on pupil size and intraocular pressure in normotensive dogs. Vet Q, 22, 179-180, 2000. DOI: 10.1080/ 01652176.2000.9695052

9. Allweiler S, Leach MC, Flecknell PA: The use of propofol and sevoflurane for surgical anaesthesia in New Zealand White rabbits. Lab Anim, 44, 113-117, 2010. DOI:

10.1258/la.2009.009036 10. Almeida DE, Nishimori CT, Oria AP, Paula DP, Nunes N, Laus JL: Effects of nitrous oxide on IOP and pupillary diameter in dogs anesthetized with varying concentrations of desflurane. Vet Ophthalmol, 11 (3): 170-176, 2008. DOI: 10.1111/j.1463-5224.2008.00616.x

11. Mori K, Ando F, Nomura H, Sato Y, Shimokata H: Relationship between intraocular pressure and obesity in Japan. Int J Epidemiol, 29, 661-666, 2000. DOI: 10.1093/ije/29.4.661

12. Komaromy AM, Garg CD, Ying GS, Liu C: Effect of head position on intraocular pressure in horses. Am J Vet Res, 67, 1232-1235, 2006. DOI: 10.2460/ajvr.67.7.1232

13. Wu SY, Nemesure B, Hennis A, Leske MC, Barbados Eye Studies Group: Nine-year changes in intraocular pressure: The Barbados eye studies. Arch Ophthalmol, 124, 1631-1636, 2006. DOI: 10.1001/archopht. 124.11.1631

14. Güzel Ö, Olğun Erdikmen D, Yıldar E, Ekici A, Şaroğlu M, Ekiz B: The effects of propofol and a diazepam/alfentanil combination in dogs aged 10 years and above on heart rate, respiratory rate, pulse oximetry data, intraocular pressure, and body temperature. Turk J Vet Anim Sci, 37, 170-176, 2013. DOI: 10.3906/vet-1201-13

15. Sator-Katzenschlager S, Deusch E, Dolezal S, Michalek-Sauberer A, Grubmüller R, Heinze G, Wedrich A: Sevoflurane and propofol decrease intraocular pressure equally during non-ophthalmic surgery and recovery. Br J Anaesth, 89, 764-766, 2002. DOI: 10.1093/bja/aef249

16. Hofmeister EH, Williams CO, Braun C, Moore PA: Propofol versus thiopental: Effects on peri-induction intraocular pressure in normal dogs. Vet Anaesth Analg, 35, 275-281, 2008. DOI: 10.1111/j.1467-2995 .2007.00385.x

17. Termühlen J, Gottschalk A, Eter N, Hoffmann EM, Aken HV, Grenzebach U, Prokosch V: Does general anesthesia have a clinical impact on intraocular pressure in children? Pediatr Anesth, 26, 936-941, 2016. DOI: 10.1111/pan.12955

18. Drummond GB: Comparison of sedation with midazolam and ketamine: Effects on airway muscle activity. Br J Anaesth, 76, 663-667, 1996. DOI: 10.1093/bja/76.5.663

19. Smith MD, Barletta M, Diehl KA, Hofmeister EH, Franklin SP: Effect of propofol and ketamine-diazepam on intraocular pressure in healty premedicated dogs. Vet Anaesth Analg, 46, 36-42, 2019. DOI: 10.1016/j. vaa.2018.09.043

20. Hofmeister EH, Mosunic CB, Torres BT, Ralph AG, Moore PA, Read MR: Effects of ketamine, diazepam, and their combination on intraocular pressures in clinically normal dogs. Am J Vet Res, 67 (7): 1136-1139, 2006. DOI: 10.2460/ajvr.67.7.1136

21. Kılıç N: A comparison between medetomidine-ketamine and xylazineketamine anaesthesia in rabbits. Turk J Vet Anim Sci, 28, 921-926 2004.

22. Artru AA, Momota Y: Trabecular outflow facility and formation rate of aqueous humor during anaesthesia with sevoflurane-nitrous oxide or sevoflurane-remifentanil in rabbits. Neurosurg Anesth, 88, 781-786, 1999. DOI: 10.1213/00000539-199904000-00019