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IOP measurements in kids more accurate using ketamine vs. sevoflurane gas sedation
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Sedating children using sevoflurane gas significantly lowers the IOP measured during ophthalmic examination while under anesthesia, a prospective study found. However, sedation achieved using intramuscular ketamine hydrochloride showed no effect on IOP, the study authors noted.
"IOP measured after ketamine sedation is more likely to represent the awake IOP than that after sevoflurane anesthesia," they said.
Dana Blumberg, MD, and colleagues at the Johns Hopkins School of Medicine, Baltimore, evaluated how the two anesthetic modalities affected IOP measurements in 30 eyes. They found that the measured IOP of eyes in the sevoflurane group was significantly lower compared with baseline. However, ketamine did not significantly affect IOP up to 6 minutes after sedation, although IOP was 7% lower when measured at 8 minutes after sedation (P = .03), according to the study.
From 2 minutes onward, systolic and diastolic blood pressures were significantly lower in the sevoflurane group vs. the ketamine group. Heart rate was also lower in the sevoflurane group up to 6 minutes after sedation, the authors noted.
"Changes in systolic blood pressure, diastolic blood pressure and heart rate caused by sevoflurane suggest that hemodynamic alterations may underlie its effects on IOP," the authors said.
Their results are published in the March issue of the American Journal of Ophthalmology.