Anesthesiology
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Randomized Controlled Trial Comparative Study
Effects of crystalloid versus colloid and the α-2 agonist brimonidine versus placebo on intraocular pressure during prone spine surgery: a factorial randomized trial.
Volume replacement with colloid solution and topical α-2 agonists may each moderate the progressive increase in intraocular pressure (IOP) during prone surgery. The authors tested the hypotheses that during prolonged prone surgery, IOP increases less with goal-directed intravenous administration of 5% albumin than with goal-directed administration of lactated Ringer's solution, and with topical α-2 agonist brimonidine than with placebo eye drops. ⋯ Brimonidine slightly reduced the primary outcome of intraoperative time-weighted average IOP, whereas there was no significant difference between goal-directed albumin or crystalloid administration. Brimonidine thus helps reduce IOP during spine surgery, but maintaining adequate blood pressure might play a more important role.