The effect of pneumoperitoneum and head‐down position on intraocular pressure

Objective Increased intraperitoneal pressure and head‐down position are associated with physiological changes including alterations of intraocular pressure. Subjects We investigated haemodynamic, respiratory and intraocular pressure changes at each phase of gynaecological laparoscopy, in 20 women of ASA I status. The same anaesthetic medication protocol was used. Systolic and diastolic blood pressure, heart rate, end‐tidal carbondioxide, pulmonary airway pressure and intraocular pressure changes were recorded continuously during pneumoperitoneum and head‐down position. Systolic and diastolic blood pressure decreased after induction of anaesthesia, increased after laryngoscopy and endotracheal intubation. Peak airway pressure increased significantly during pneumoperitoneum and decreased after deflation. Intraocular pressure decreased significantly after induction of anaesthesia and remained unchanged during the pneumoperitoneum and head‐down position. Conclusion In conclusion, adequate depth of anaesthesia may prevent intraocular pressure increase caused pneumoperitoneum and head‐down position. Further studies are required to clarify the picture both in experimental animals and in human.