Effects of crystalloid versus colloid and the alpha-2 agonist brimonidine versus placebo on intraocular pressure during prone spine surgery: a factorial randomized trial.

This factorial randomized trial evaluated the effects of two different treatments on intraocular pressure increases during prone spine surgery. The first treatment consisted in the administration of either 5% albumin or Lactated Ringer’s solution guided by esophageal doppler. The second treatment consisted in the topical administration of either the alpha-2 agonist brimonidine or placebo eye drops. The authors report that topical brimonidine slightly reduced intraoperative time-weighted average intraocular pressure whereas 5% albumin infusion was associated with a slower intraocular pressure increase in comparison to Lactated Ringer’s. Although the results of this study were not very conclusive, it stresses the necessity to carefully monitor intraocular pressure during prolonged prone surgery.

– Philippe Van der Linden