The Influence of Prone Position for Spinal Surgery on Visual Acuity

Vision; Disorder, Loss Clinical Trial

Official title:

The Influence of Prone Position for Spinal Surgery on Visual Acuity, a Comparison of Volatile Anesthesia With Desflurane to Total Intravenous Anesthesia With Propofol

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT03644641
• Other study ID #: UHospital Hradec Kral
• Status: Not yet recruiting
• Phase: N/A
• Start date: November 28, 2025
• Est. completion date: December 30, 2029

Study information

• Verified date: May 2024
• Source: University Hospital Hradec Kralove
• Contact: Vlasta Dostalova, MD, Ph.D.
• Phone: +420777883571
• Email: vlasta.dostalova[@]fnhk.cz
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This study investigated the effect of desflurane and propofol anesthesia on visual acuity in patients in prone position for spinal surgery. Many trials have investigated the effects of different anesthetic agents on intraocular pressure, propofol may reduce intraocular pressure more than other intravenous anesthetics.

Description:

Perioperative increase in intraocular pressure can be caused by prone positioning. In addition to surgical factors, patients with glaucoma, uncontrolled hypertension, arthrosclerosis, and morbid obesity are at risk for potentially damaging optic nerve and loss of optic nerve function. Some studies found that intraocular pressure values were significantly lower in patients undergoing propofol total intravenous anesthesia than in patients undergoing desflurane anesthesia during intraoperative positional changes. Pronounced vasodilatation caused by desflurane might produced hyperaemia with higher intraocular pressure. Hemodynamic response to prone position measured by near-infrared spectroscopy (NIRS) on the prefrontal cortex could determine changes caused by prone position.

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 60
• Est. completion date: December 30, 2029
• Est. primary completion date: November 30, 2028
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 65 Years

Eligibility

Inclusion Criteria:

• Glasgow Coma scale 15

• American Society of Anesthesiologists (ASA) Physical Status Classification System I-III

• spinal surgery in duration less than 3 hours

• sinus rhythm

Exclusion Criteria:

• postoperative artificial ventilation

• serious neurological disease

• lung disease with hypercapnia

• propofol allergy

Related Conditions & MeSH terms

• Vision; Disorder, Loss

Intervention

Procedure:
• Desflurane Group
General anesthesia will be held using desflurane in end- tidal concentration according to target value of entropy levels (between 40 and 60).
• Propofol Group
General anesthesia will be held using Schnider effect model for propofol (target control anesthesia). Titration will be done according to target value of entropy levels (between 40 and 60).

Locations

Country	Name	City	State
Czechia	University Hospital Hradec Kralove	Hradec Kralove

Sponsors (1)

Lead Sponsor	Collaborator
University Hospital Hradec Kralove

Country where clinical trial is conducted

Czechia, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Visual injury	worsening of test for visual acuity (Rodenstock)	48 hours