The Effect of Sevoflurane Versus Total Intravenous Anesthesia on Intraocular Pressure in Patients Undergoing Coronary Artery Bypass Graft Surgery with Cardiopulmonary Bypass: A Prospective Observational Study

Zeynep Yasemin Tavsanoglu; Ali Sait Kavakli; Senay Canim Erdem; Arzu Karaveli; Ulku Arslan; Adnan Yalcinkaya; Ali Umit Yener; Berna Dogan

doi:10.3390/medicina61060975

The Effect of Sevoflurane Versus Total Intravenous Anesthesia on Intraocular Pressure in Patients Undergoing Coronary Artery Bypass Graft Surgery with Cardiopulmonary Bypass: A Prospective Observational Study

Medicina (Kaunas). 2025 May 25;61(6):975. doi: 10.3390/medicina61060975.

Authors

Zeynep Yasemin Tavsanoglu¹, Ali Sait Kavakli², Senay Canim Erdem¹, Arzu Karaveli¹, Ulku Arslan³, Adnan Yalcinkaya⁴, Ali Umit Yener⁴, Berna Dogan⁵

Affiliations

¹ Department of Anesthesiology and Reanimation, University of Health Sciences Antalya Training and Research Hospital, 07100 Antalya, Turkey.
² Department of Anesthesiology and Reanimation, Faculty of Medicine, Istinye University, 34396 Istanbul, Turkey.
³ Department of Anesthesiology and Reanimation, Faculty of Medicine, Akdeniz University, 07058 Antalya, Turkey.
⁴ Department of Cardiovascular Surgery, University of Health Sciences Antalya Training and Research Hospital, 07100 Antalya, Turkey.
⁵ Department of Ophtalmology, University of Health Sciences Antalya Training and Research Hospital, 07100 Antalya, Turkey.

Abstract

Background and Objectives: The aim of this study was to compare the effects of sevoflurane-based anesthesia and propofol-based total intravenous anesthesia (TIVA) on intraocular pressure (IOP) during coronary artery bypass graft surgery (CABG) with cardiopulmonary bypass (CPB). Materials and Methods: This prospective observational monocentric study included 68 patients scheduled for CABG with CPB, divided into two groups of propofol-based TIVA (Group P) and sevoflurane-based anesthesia (Group S). Intraocular pressure was measured and recorded at eight predefined time points using a tonometer: before anesthesia induction (T1), 10 min after induction (T2), immediately before the beginning of CPB (T3), 3 min after the beginning of CPB (T4), 3 min after cross-clamping (T5), 3 min after cross-clamp removal (T6), immediately before the weaning of CPB (T7), and at the end of the surgery (immediately after skin closure) (T8). The primary endpoint was to examine the effects of propofol-based TIVA and sevoflurane-based anesthesia methods on IOP during CABG operation. The secondary endpoints included a comparison of hemodynamic variables, blood gas values, and intensive care unit (ICU) and hospital stays. Results: Intraocular pressure values were similar for both groups at all time points. A statistically significant decrease was found in IOP in all measurements after induction compared to pre-induction values in both Group P and Group S (p < 0.05). Compared to IOP measured at 10 min after induction, no statistically significant difference was found at all subsequent time points in both groups. When the right and left IOP values were compared, no statistically significant difference was detected at all time points in both Group P and Group S. Conclusions: The results of the study indicated that propofol-based TIVA and sevoflurane-based anesthesia had similar effects on IOP in patients undergoing CABG with CPB.

Keywords: cardiac surgery; cardiopulmonary bypass; coronary artery bypass grafting; intraocular pressure; propofol; sevoflurane.

Publication types

Observational Study
Comparative Study

MeSH terms

Aged
Anesthesia, Intravenous* / adverse effects
Anesthesia, Intravenous* / methods
Anesthetics, Inhalation* / therapeutic use
Anesthetics, Intravenous / therapeutic use
Cardiopulmonary Bypass* / methods
Coronary Artery Bypass* / methods
Female
Humans
Intraocular Pressure* / drug effects
Male
Methyl Ethers* / adverse effects
Methyl Ethers* / therapeutic use
Middle Aged
Propofol / adverse effects
Propofol / therapeutic use
Prospective Studies
Sevoflurane

Substances

Sevoflurane
Propofol
Anesthetics, Inhalation
Anesthetics, Intravenous
Methyl Ethers