The impact of anesthetic modality and cardiopulmonary bypass flow type on intraoperative intraocular…

Randomized trialMedicine· Jan 2026

The impact of anesthetic modality and cardiopulmonary bypass flow type on intraoperative intraocular pressure during coronary artery bypass grafting: A prospective, randomized controlled trial.

Dilek Uçak, Hatice Şimşek Ülkü, Emine Çiloğlu, Tolga Onur Badak

Cardiac & Thoracic AnesthesiaRandomized trialClinical practiceQ4IF 0.3

Propofol-based total intravenous anesthesia lowered intraocular pressure more than sevoflurane after induction

The impact of anesthetic modality and cardiopulmonary bypass flow type on intraoperative intraocular pressure during coronary artery bypass grafting: A prospective, randomized controlled trial.

Dilek Uçak … Tolga Onur Badak

Medicine · Jan 2026 · Q4 in General Medicine

Background

Intraocular pressure (IOP) is an indirect marker of ocular perfusion and is critical during coronary artery bypass grafting (coronary artery bypass grafting) due to potential hemodynamic instability.

Methods

This prospective, randomized controlled trial included 160 patients undergoing coronary artery bypass grafting, randomized into four groups (n = 40 each): Sevoflurane + pulsatile cardiopulmonary bypass (SP), sevoflurane + nonpulsatile cardiopulmonary bypass (SN), TIVA + pulsatile cardiopulmonary bypass (TP), and TIVA + nonpulsatile cardiopulmonary bypass (TN).

n = 160 patients

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Results

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mm Hg

propofol lowered eye pressure more than sevoflurane after induction

n = 160 patients

More results

The combined effects of anesthetic modality (sevoflurane vs propofol-based total intravenous anesthesia [TIVA]) and cardiopulmonary bypass (cardiopulmonary bypass) flow type (pulsatile vs nonpulsatile) on intraoperative IOP during coronary artery bypass grafting are not well established.

More results

Upon cardiopulmonary bypass initiation, IOP increased in all groups, most prominently in the SN group (P < .01).

Pulsatile flow was associated with significantly lower IOP values than nonpulsatile flow (P < .01), irrespective of anesthetic modality.

The TP group exhibited the most stable IOP profile throughout surgery (P < .05).

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Conclusion

Although IOP fluctuations remained within subclinical limits, these findings suggest that TIVA combined with pulsatile cardiopulmonary bypass may offer advantages in maintaining ocular hemodynamic stability, particularly in high-risk patients.

The impact of anesthetic modality and cardiopulmonary bypass flow type on intraoperative intraocular pressure during coronary artery bypass grafting: A prospective, randomized controlled trial.

The impact of anesthetic modality and cardiopulmonary bypass flow type on intraoperative intraocular pressure during coronary artery bypass grafting: A prospective, randomized controlled trial.

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