Role of Remifentanil in Prevention Increase of Intraocular Pressure after Suxamethonium Injection
Main Article Content
Abstract
Background: Succinylcholine is used to facilitate rapid tracheal intubation in patients who are at risk of aspiration of gastric contents. However, administration of succinylcholine and tracheal intubation are associated with an increase in intraocular pressure (IOP). Opioids generally attenuates this increase in IOP but may be associated with respiratory depression. Remifentanil has a rapid onset (time to peak effect 60-70 s), is metabolized rapidly and therefore respiratory depression should be short-lived. We have studied the efficacy of remifentanil in pre venting an increase in IOP after administration of succinylcholine and tracheal intubation in a double- blind, randomized study .
Aim: To evaluate the role of REMIFENTANIL in decreasing IOP after succinylcholine injection and tracheal intubation (RAPID SEQUENCE INDUCTION).
Patient and method: It is a prospective, randomized double blinded clinical trial, done on 36 patients who had elective surgery in ophthalmology department ,after taking patients consent, we had studied changes in IOP after succinylcholine injection and tracheal intubation 3 different times , by dividing patients in two groups, group R who takes Remifentanil 1µg/kg and propofol 2mg/kg induction ,and group C who received 5 ml normal saline with propofol 2mg/kg induction.
Results: Patients respond well, IOP had been decreased significantly in remifentanil
group. We found that P-Value between the two groups were less than 0.05.
Conclusion: Remifentanil has significant role on decreasing IOP in rapid sequence induction and tracheal intubation.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
I. Alwitry A, Koshy Z, Browning AC, Kiel W, Holden R. The effect of sub-Tenon’s anaesthesia on intraocular pressure. Eye 2001; 15: 733–5.
II. Kelly RE, Dinner M, Turner LS, Haik B, Abramson DH, Davies P. Succinylcholine increases intraocular pressure in the human eye with the extra ocular muscles detached. Anesthesiology 1993; 79: 948–52.
III. Nicholas CB Pritchard. ANAESTHESIA AND INTENSIVE CARE MEDICINE 11:10 General anaesthesia for ophthalmic surgery 2010 Published by Elsevier Ltd.
IV. Sung YF, Stulting RD, Beatie CD, et al. Intraocular pressure (IOP) effects of remifentanil (R) (GI87084B) and alfentanil (A) [abstract].Anesthesiology 1994; 81: A35.
V. R. Alexander, R. Hill Remifentanil prevents an increase in intraocular pressure after succinylcholine and tracheal intubation British Journal of Anesthesia 1998; 81: 606-607.
VI. H.P. Ng Effect of remifentanil compared with fentanyl on intraocular pressure after succinylcholine and tracheal intubation Br. J. Anaesth.(2000) 85 (5): 785-787.
VII. Bowman R, Liu C, Sarkies N. Intraocular pressure changes after peribulbar injections with and without ocular compression. Br J Ophthalmol 1996; 80:394–7.