Evaluating the impact of lateral position alterations on intraocular pressure and cerebral oxygen saturation among elderly and middle-aged patients undergoing surgery

Abstract

Objective

To assess the impact of lateral position changes on intraocular pressure and regional cerebral oxygen saturation (rScO₂) in patients undergoing surgery.

Methods

Seventy patients were categorized into the elderly and middle-aged groups, with 35 individuals in each. Apart from collecting physiological data of patients, intraocular pressure was measured using a rebound tonometer, and regional cerebral oxygen saturation levels were assessed with a cerebral oxygen monitor at ten different time points in this study.

Results

Intraocular pressure trends in both eyes were similar in both groups, peaking after two hours and then stabilizing. The intraocular pressure of the eye on the compressed side increased after lateral positioning, and this was more notable in the elderly group, indicating a significant difference (P < 0.05). The rScO₂ levels did not differ significantly between the groups (P > 0.05); however, patients in the elderly group exhibited higher mean arterial pressure (MAP) fluctuations at post-intubation (T2) and pre-turning (T8) time points compared to those in the middle-aged group, and this difference was significant (P < 0.05). In the middle-aged group, there was no correlation between MAP and changes in cerebral oxygen saturation (P > 0.05), whereas a weak correlation was present in the elderly group (P < 0.05). There was no difference in uncorrected visual acuity between the pre-admission and six hours post-surgery time points (P > 0.05).

Conclusion

The results of this study underscores the importance of proper positioning of patients, enhanced intraoperative monitoring, and safe surgical positioning practices.