Effects of Inhalation Anaesthesia and Total Intravenous Anaesthesia on Intraocular Pressure in Robotic Prostate Surgery

Objective: This study aimed to compare the effects of inhalation anesthesia and total intravenous anesthesia on intraocular pressure, as well as to evaluate associated hemodynamic changes, surgical duration, blood gas parameters, and the effects of pneumoperitoneum and steep trendelenburg positioning at different time intervals in patients undergoing robotic prostatectomy. Robot-assisted laparoscopic prostatectomy (RALP) is widely used in the surgical treatment of prostate cancer. Due to patient characteristics, operative duration, and the requirement for a steep Trendelenburg position, RALP is associated with specific physiological changes. One of the most important concerns is the increase in intraocular pressure (IOP), which may lead to ocular complications. This study aimed to compare the effects of inhalation anesthesia and total intravenous anesthesia (TIVA) on intraoperative IOP changes during robotic prostate surgery. Methods: This prospective randomized study included 60 patients scheduled for elective robotic prostatectomy following ethics committee approval. Patients were randomly allocated into two groups: Group 1 received sevoflurane–remifentanil anesthesia, and Group 2 received propofol–remifentanil anesthesia. Intraocular pressure, hemodynamic variables, blood gas parameters, respiratory mechanics, heart rate (HR), systolic, diastolic and mean blood pressures (SBP, DBP, MBP), bispectral index (BIS), peripheral oxygen saturation (SpO₂), and end-tidal carbon dioxide (ETCO₂) were recorded at predefined time points from anesthesia induction to the postoperative period. Results: Demographic characteristics, comorbidities, anesthesia duration, Trendelenburg duration, pneumoperitoneum duration, and surgical time were comparable between the groups (P>.05). No statistically significant difference was observed between the groups with respect to right or left intraocular pressure (IOP) measurements throughout the study period (P>.05). End tidal carbon dioxide (ETCO₂) levels and mean airway pressure were significantly higher in the sevoflurane group (P