Abstract
One hundred and sixty patients, divided randomly into four groups received normal saline (5 ml), d-tubocurarine (0.05 mg· kg-1), diazepam (0.1 mg·kg-1) or lidocaine (1 mg·kg-1) as pretreatment, in a double blind manner, five minutes before anaesthetic induction with thiopentone and succinylcholine (1 mg·kg-1). Succinylcholine caused a significant increase in IOP in all groups. However, in the lidocaine group, this increase was significantly less than that observed in the control group. The post-succinylcholine increase in IOP was further aggravated by tracheal intubation in all except the lidocaine group. A further clinical trial with higher doses of lidocaine is suggested to assess its ability to obtund the succinylcholine-induced increase in IOP. Lidocaine in a dose of 1 mg·kg-1 IV prevents the rise in IOP which follows intubation.
Résumé
Cent soixante patients divisés ďune façon randomisée en quatre groupes ont reçu du salin physiologique (5 ml), de la d-tubocurarine (0.05 mg·kg-1), du diazepam (0.1 mg·kg-1) ou de la lidocaine (1 mg·kg-1) comme pré-traitment à double insu, cinq minutes avant ľinduction de ľanesthésie avec du thiopentone et de la succinylcholine (1 mg·kg-1). La succinylcholine a provoqué une augmentation significative de la pression intraoculaire chez tous les groupes. Cependant, pour le groupe lidocaine, cette augmentation était significativement moindre que celle observée chez le groupe contrôle. Ľaugmentation de la pression intraoculaire post succinylcholine était davantage aggravée par ľintubation trachéale chez tous les groupes à ľexception du groupe lidocaine. Un essai clinique ultérieur avec de plus fortes doses de lidocaine est suggéré afin ďévaluer sa capacité de diminuer ľaugmentation de la pression intraoculaire induite par la succinylcholine malgré qu’elle est suffisante aux doses de 1 mg·kg-1 pour prévenir ľaugmentation de la pression intra-oculaire après ľintubation.
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References
Lincoff HA, Ellis CH, Devoe AGet al. The effect of succinylcholine on intraocular pressure. Am J Ophthalmol 1955; 40: 501–10.
Pandey K, Badola RP, Kumar S. Time course of intraocular hypertension produced by suxamethonium. Br J Anaesth 1972; 44: 191–6.
Miller RD, Way WL, Hickey RF. Inhibition of succinylcholine-induced increased intraocular pressure by non-depolarising muscle relaxants. Anesthesiology 1968; 29: 123–6.
Cunningham AJ, Albert O, Cameron J, Watson AG. The effect of intravenous diazepam on rise of intraocular pressure following succinylcholine. Can Anaesth Soc J 1981; 28: 591–6.
Meyers EF, Krupin T, Johnson M, Zink H. Failure of non-depolarising neuromuscular blockers to inhibit succinylcholine-induced increased intraocular pressure; a controlled study. Anesthesiology 1978; 48: 149–51.
Cook JH. The effect of suxamethonium on intraocular pressure. Anaesthesia 1981; 36: 359–65.
Feneck RO, Cook JF. Failure of diazepam to prevent the suxamethonium-induced rise in intraocular pressure. Anaesthesia 1983; 38: 120–7.
Fry ENS. Use of propanidid and lignocaine to reduce succinylcholine induced fasciculations. Br J Anaesth 1975; 47: 723–7.
Abou-Madi MN, Keszler H, Yacoub JM. Cardiovascular reactions to laryngoscopy and tracheal intubation following small and large intravenous doses of lidocaine. Can Anaesth Soc J 1977; 24: 12–9.
Hamill JF, Bedford RF, Weaver DC, Colohan AR. Lidocaine before endotracheal intubation: I/V or local. Anesthesiology 1981; 55: 578–81.
Lerman J, Kiskis AA. Lidocaine attenuates the intraocular pressure response to rapid intubation in children. Can Anaesth Soc J 1985; 32: 339–45.
Spoerel WE. Rebreathing and carbon dioxide elimination with the Bain Circuit. Can Anaesth Soc J 1980; 27: 357–62.
Donlon JV. Anesthesia for Eye, Ear, Nose and Throat.In: Anesthesia Miller RD (Ed.). New York: Churchill Livingstone 2nd edition, 1986, p. 1837–94.
Miller SJH. Parson’s Diseases of the Eye. New York: Churchill Linvingstone, 17th edition, 1984, p. 79.
Erkola O, Salmenpera M, Tammisto T. Does diazepam pretreatment prevent succinylcholine induced fasciculations? A double blind comparison of diazepam and tubocurarine pretreatments. Anesth Analg 1980; 59: 932–4.
Eisenberg M, Balsley S, Katz RL. Effect of diazepam on succinylcholine-induced myalgia, potassium rise, CPK elevation and relaxation. Anesth Analg 1979; 58: 314–7.
Duncalf D, Foldes FF. Effect of anaesthetic drugs and muscle relaxants on intraocular pressure. International Ophthalmology Clinics 1973; 13: 21–33.
Adam AK, Barnett KC. Anaesthesia and intraocular pressure. Anaesthesia 1966; 21: 202–10.
Wynands JE, Crowell DE. Intraocular tension in association with succinylcholine and endotracheal intubation: a preliminary report. Can Anaesth Soc J 1960; 7: 39.
Goldsmith E. An evaluation of succinylcholine and gallaminc as muscle relaxants in relation to intraocular tension. Anesth Analg 1967, 46: 557–61.
Duncalf D, Rhodes DH. Anaesthesia in clinical ophthalmology. Baltimore, The Williams and Wilkins Co. 1963. Chapter 9, p. 98.
Barr AM, Thornley BA. Thiopentone and pancuronium crash induction. A comparison with thiopentone and suxamethonium. Anaesthesia 1978; 33: 25–31.
Churchill-Davidson HC (Ed). A practice of Anaesthesia. Hong Kong: PG Publishing Pte Ltd. 1984. Chapter 25, p. 728.
Cullen DJ. The effect of pretreatment with non-depolarizing muscle relaxants on the neuromuscular blocking action of succinylcholine. Anesthesiology 1971; 35: 572–8.
Matthews PBC. Muscle spindles and their motor control. Physiol Rev 1964; 44: 246.
Poulton TJ, James EM. Cough suppression by lidocaine. Anesthesiology 1979; 50: 470–2.
Smith RB, Babinski M, Leano N. The effect of lidocaine on succinylcholine-induced rise in intraocular pressure. Can Anaesth Soc J 1979; 26: 482–3.
Duncalf D, Weitzner SW. The influence of ventilation and hypercapnea on intraocular pressure during anesthesia. Anesth Analg 1963; 42: 232.
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Mahajan, R.P., Graver, V.K., Munjal, V.P. et al. Double-blind comparison of lidocaine, tubocurarine and diazepam pretreatment in modifying intraocular pressure increases. Can J Anaesth 34, 41–45 (1987). https://doi.org/10.1007/BF03007680
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DOI: https://doi.org/10.1007/BF03007680