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Effect Of Dexmedetomidine Premedication On The Intraocular

Pressure

Changes After Succinylcholine And Intubation

Mowafi, HA; Aldossary, N; Ismail, SA; Alqahtani, J

OXFORD UNIV PRESS, BRITISH JOURNAL OF ANAESTHESIA; pp: 485-489; Vol: 100

King Fahd University of Petroleum & Minerals

http://www.kfupm.edu.sa

Summary

Background. Succinylcholine is still recommended for some situations in open globe

injuries. However, the use of succinylcholine is associated with an increase in

intraocular pressure (IOP). This may be deleterious in open globe injuries. No method

has previously been shown to abolish completely this rise in the IOP. We investigated

whether dexmedetomidine, an alpha-2 agonist, could attenuate this increase in the

IOP after succinylcholine and intubation. Methods. Forty patients with no pre-existing

eye disease undergoing general anaesthesia were randomly premedicated by i.v.

dexmedetomidine 0.6 mu g kg(-1), or saline. Heart rate (HR), mean arterial pressure

(MAP), and IOP (using Schioetz tonometer) were measured before, after the

premedication, after thiopental, after succinylcholine, immediately after intubation,

and then every 2 min for 6 min. Results. Succinylcholine and intubation increased

IOP in both groups. However, in the dexmedetomidine group, the IOP rise was not

different from the baseline value (P = 0.65) and was significantly lower than in the

saline group (P = 0.003). After intubation, the MAP in the control group was higher

than that in the dexmedetomidine group (P = 0.041) and exceeded the baseline value

(P < 0.001). The HR also showed less fluctuation in the dexmedetomidine group than

in the saline group. Conclusions. We conclude that dexmedetomidine could be a

beneficial premedication in open globe injuries.

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