THE EFFECT OF SMOKING ON INTRAOCULAR PRESSURE INCREASE AFTER ENDOTRACHEAL INTUBATION

Öz

This study investigates the effect of smoking on intraocular pressure (IOP) following endotracheal intubation. Endotracheal intubation is known to cause transient increases in IOP, which may pose risks for patients with preexisting ocular conditions. However, the influence of smoking on these changes remains unclear. By comparing IOP variations among smokers, former smokers, and non-smokers, this study aims to provide insights into the relationship between smoking and IOP fluctuations during general anesthesia. A total of 150 adult patients (ages 18–40) undergoing elective surgery under general anesthesia were included. Patients were classified into three groups: smokers, former smokers, and non-smokers. Standardized anesthetic protocols were applied to all participants, and IOP measurements were taken using a Tono-Pen XL device at baseline (pre-induction), post-induction, immediately after intubation, and at 10- and 20-minutes post-intubation. Mean arterial pressure (MAP) was also recorded at these times. Statistical analyses were conducted using SPSS 20.0, applying appropriate tests for intergroup and intragroup. Baseline IOP values were similar across all groups. After induction, IOP decreased in all patients but significantly increased following intubation. Smokers exhibited a more pronounced rise in IOP post-intubation compared to non-smokers and former smokers (p < 0.01). At the 10th and 20th minutes, IOP values declined but remained higher in smokers than in the other groups. No significant differences were observed in MAP values between groups, suggesting that systemic blood pressure changes did not account for the observed IOP differences. Smoking appears to exacerbate the increase in IOP following endotracheal intubation, posing potential risks for ocular health, particularly in patients susceptible to glaucoma. These findings highlight the need for careful anesthetic management in smokers to mitigate IOP spikes during intubation.

Anahtar Kelimeler

• Anesthesia
• Endotracheal intubation
• Intraocular pressure
• Ocular health
• Smoking

ENDOTRAKEAL ENTÜBASYON SONRASI SİGARA KULLANIMININ GÖZ İÇİ BASINÇ ARTIŞINA ETKİSİ

Öz

Bu çalışma, endotrakeal entübasyon sonrasında sigara kullanımının göz içi basıncı (GİB) üzerindeki etkisini araştırmaktadır. Endotrakeal entübasyonun GİB' de geçici artışlara neden olduğu bilinmektedir ve bu durum önceden oküler rahatsızlıkları olan hastalar için risk oluşturabilir. Bununla birlikte, sigara içmenin bu değişiklikler üzerindeki etkisi belirsizliğini korumaktadır. Bu çalışma, sigara içenler, daha önce sigara içmiş olanlar ve içmeyenler arasındaki GİB değişimlerini karşılaştırarak, genel anestezi sırasında sigara içme ve GİB dalgalanmaları arasındaki ilişki hakkında bilgi sağlamayı amaçlamaktadır. Genel anestezi altında elektif cerrahi geçiren toplam 150 yetişkin hasta (18-40 yaş) çalışmaya dahil edilmiştir. Hastalar üç gruba ayrılmıştır: sigara içenler, eskiden sigara içenler ve sigara içmeyenler. Tüm katılımcılara standart anestezi protokolleri uygulanmış ve GİB ölçümleri Tono-Pen XL cihazı kullanılarak başlangıçta (indüksiyon öncesi), indüksiyon sonrası, entübasyondan hemen sonra ve entübasyondan 10 ve 20 dakika sonra alınmıştır. Ortalama arter basıncı (MAP) da bu zaman noktalarında kaydedilmiştir. İstatistiksel analizler SPSS 20.0 kullanılarak, gruplar arası ve grup içi uygun testler uygulanarak gerçekleştirilmiştir. Başlangıç GİB değerleri tüm gruplarda benzerdi. İndüksiyondan sonra, GİB tüm hastalarda düşmüş ancak entübasyondan sonra önemli ölçüde artmıştır. Sigara içenler, içmeyenlere ve eski içicilere kıyasla entübasyon sonrası GİB'de daha belirgin bir artış sergilemiştir (p < 0,01). 10. ve 20. dakikalarda GİB değerleri düşmüş ancak sigara içenlerde diğer gruplara kıyasla daha yüksek kalmıştır. Gruplar arasında MAP değerlerinde anlamlı bir fark gözlenmemiştir, bu da sistemik kan basıncı değişikliklerinin gözlenen GİB farklılıklarını açıklamadığını düşündürmektedir. Sigara içmenin endotrakeal entübasyonu takiben GİB artışını şiddetlendirdiği ve özellikle glokoma yatkın hastalarda oküler sağlık için potansiyel riskler oluşturduğu görülmektedir. Bu bulgular, entübasyon sırasında GİB artışını azaltmak için sigara içenlerde dikkatli anestezi yönetimi ihtiyacını vurgulamaktadır.

Anahtar Kelimeler

• Anestezi
• Endotrakeal entübasyon
• Göz içi basıncı
• Oküler sağlık
• Sigara

Kaynakça

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