Abstract

P 167

Does sedation with midazolam influence the intraocular pressure in children?

Oberacher-Velten I.¹, Prasser C.², Ittner K.-P.², Lorenz B.^1
1Department of Paediatric Ophthalmology, Strabismology, and Ophthalmogenetics, University of Regensburg, ²Department of Anaesthesiology, University of Regensburg

Objective: To investigate the possible influence of sedation with midazolam on the applanatory measured intraocular pressure (IOP) in children.
Methods: In 44 eyes of 22 normal children without glaucoma (mean age 3.52±1.37 years, body weight £20 kg) undergoing general anaesthesia for other reasons (e.g. strabismus surgery, lacrimal duct stenosis) measurements of the IOP using Perkins applanation techniques were performed before and 15 and 30 minutes after sedation with midazolam (1 mg/kg) orally. In each child and at each time the IOP was measured three times, and the average of these three measurements was taken for statistical analysis. Sedation was estimated by the Michigan sedation score. The intraindividual IOP courses were analysed and correlated with sedation scores.
Results: In all children, measurement of the IOP was easily possible after sedation with midazolam. The mean IOP was 12.24±3.04 mmHg before sedation, 11.83±3.02 mmHg at 15, and 11.68±3.10 mmHg at 30 minutes after sedation with midazolam. Using the paired t-test, the IOP was significantly higher before sedation compared with the values taken 15 and 30 minutes after sedation with midazolam (p=0.012). There was no statistically significant correlation between the intraindividual IOP courses and sedation scores.
Conclusions: Although there was a statistically significant IOP decrease after sedation with midazolam compared with the IOP values taken awake, the small relative IOP decrease appears to be negligible in the clinical situation. Additionally one has to take into consideration that the mental stress preoperatively might have elevated the IOP in some children before sedation. Thus sedation with midazolam orally appears to be a reliable, well tolerated, safe method to examine the IOP using applanation techniques in children.

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