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Laryngeal mask airway insertion can cause IOP increase in children
Children who have a laryngeal mask inserted into their airway while receiving general anesthesia for ophthalmic surgery can experience a small but significant increase in IOP, according to a study by researchers in the United Kingdom.
"It is recommended that the measurement of IOP in children receiving a general anesthetic is carried out before the insertion of the [laryngeal mask airway]," the authors said.
Patrick Watts, FRCOphth, and colleagues measured IOP in 66 children before and 1 minute after laryngeal mask airway (LMA) insertion. All children were younger than 16 years, averaging 5.5 years of age, and were scheduled to undergo elective ophthalmic surgery involving general anesthesia.
Children with a history of either glaucoma or previous intraocular surgery were excluded from the study, the authors noted.
Investigators found that IOP significantly increased in both eyes after LMA insertion.
Among patients' right eyes, IOP averaged 13.6 mm Hg before LMA insertion and increased to average 15.5 mm Hg post-insertion. For the patients' left eyes, IOP averaged 13.6 mm Hg before LMA insertion and increased to average 15.2 mm Hg after LMA insertion (P = .001), according to the study.
The researchers found a significant association between decreases in blood pressure and increased IOP (P = .008). Additionally, "the interaction between the change in [blood pressure, heart rate] and CO2 affected the change in IOP measured after insertion of the LMA (P = .04)," the authors said.
No correlation was found between patients' ages and changes in IOP, they noted.
The study is published in the October issue of American Journal of Ophthalmology.