[Intra-ocular pressure changes during laparoscopic cholecystectomy].

Intra-ocular pressure (IOP) was measured during laparoscopic cholecystectomy (n = 20) under continuous epidural block and nitrous oxide-oxygen anesthesia. There was a slight but significant increase in IOP and peak airway pressure when the abdominal CO2 insuffration was started, and the IOP recovered to the preoperative level after the postural change to the head-up position. It was not associated with any significant change in mean arterial pressure and end-tidal CO2. In one ocular hypertension case undergoing laparoscopic chorecystectomy and appendectomy, however, there was profound increase in IOP during abdominal CO2 insuffration with head down position. We speculate that it was due to the effect of increased CVP with abdominal CO2 insuffration and postural change on the IOP. Thus the laparoscopic operation with head-down position should be avoided in patients with ocular hypertension.