An Evaluation SUCCINYLCHOLINE AND GALLAMINE AS MUSCLE RELAXANTS in relation to intraocular tension

Goldsmith, E. L.

doi:10.1213/00000539-196709000-00014

Cited by 9 publications

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“…It should be pointed out that topical anaesthetic agents were not used on larynx and trachea, since this has been shown to influence the intra-ocular pressure fo]lowing intubation after the administration of gallamine. 6 The fall in intraocular pressure which was fairly consistent in both groups three minutes after intubation cannot be ascribed solely to the muscle relaxants. Barbiturate and hydroxyzine have both been shown to reduce intraocular pressure in man.…”

Section: Commentsmentioning

confidence: 82%

Intraocular pressure following pancuronium

Smith

Leano

1973

Canad. Anaesth. Soc. J.

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THE NON-DEPOLARIZING MUSCLE RELAXANT D-TUBOCURARINE has been shown to lower iutraoeular pressure. 1,2 A small dose of d-tuboeurarine given before suceinylcholine has been reported to abolish or reduce the rise in intraoeular pressure caused by the latter. 3 This investigation was done to compare the effect on intraoeular pressure of pancuronium and suecinylcholine in patients pretreated with a small dose of d-tubocurarine. METHODFourteen patients in ASA Physical Status I and II, aged from 17 to 70 years were studied during anaesthesia for minor operations on the head and neck. All were premedicated with pentobarbitone 2 mg/kg to a maximum of 150 mg, hydroxyzine 50 mg and atropine 0.6 rag. Monitoring was by means of a precordial stethoscope, blood pressure measurements and cardioscope.In the test group of eight patients anaesthesia was induced with sodium thiamylal 5 mg/kg followed by fentanyl 4/zg/kg. After the loss of the lid reflex, postinduction intraocular pressure readings were made using a Schiotz tonometer with a 5.5 gm weight. Pancuronium 0.1 mg/kg was administered and after two minutes the intraocular pressure was measured again and the trachea was then intubated. Intraocular pressure readings were made at one minute intervals for 10 minutes thereafter. Maintenance of anaesthesia was with 50 per cent nitrous oxide and 50 per cent oxygen.In the control group of 6 patients, 3 nag d-tubocurarine was first administered. Anaesthesia was then induced with sodium thiamylal 5 mg/kg followed by fentanyl 4/xg/kg, as in the test group. After loss of the lid reflex, the post-induction intraocular pressure measurement was made. Succinylcholine 1.5 mg/kg was then given, 3 minutes after the d-tubocurarine. One minute later the intraocular pressure was measured and the trachea was intubated. The intraoeular pressure was measured at one minute intervals for 10 minutes, and anaesthesia again maintained with 50 per cent nitrous oxide and 50 per cent oxygen.Intraocular pressure measurements were made in both eyes except when a pathological condition existed in one eye. Arterial blood gas determinations were done on most patients after intubation. Topical anaesthesia of the larynx and trachea was not applied in any of the patients. RESULTSThe readings of the intraocular pressure in the test group and control group are shown in Tables I and II respectively. Thev are compared graphically by

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Section: Commentsmentioning

confidence: 82%

Intraocular pressure following pancuronium

Smith

Leano

1973

Canad. Anaesth. Soc. J.

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“…MILLER et al (1968) found gallamine 20 mg in combination with thiopentone 25 to 75 mg to have no effect on IOP. I n another study, also using the indentation principle, gallamine failed to decrease I O P when given after thiopentone (GOLDSMITH 1967). DRUCKER et al (1951) found no significant change in IOP in conscious volunteers after D-tubocurarine 0.1345 mg/kg, probably because of difficult recording conditions with the Schiotz tonometer due to pronounced extraocular muscle paresis and subsequent eye rotation.…”

Section: Discussionmentioning

confidence: 96%

Some Aspects of Ocular Function after Precurarization

Eriksen

Bramsen

Hommelgaard

1977

Acta Anaesthesiol Scand

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Small doses of nondepolarizing relaxants are often recommended as prior medication to suxamethonium in order to avoid or attenuate the side effects elicited by the latter drug. After D-tubocurarine (0.05 mg/kg b.w. and 0.075 mg/kg b.w.) in unmedicated volunteers, a dose-dependent recession of the monocular near point of accomodation was recorded. This recession, which parallelled the decrease in grip strength, was 4 cm and 9 cm, respectively. The same doses evoked an exophoria of 14 and 17 prism diopters, respectively. Intraocular pressure was significantly lowered by D-tubocurarine 0.05 mg/kg b.w., from 2.01 kPa (15.1 mmHg) to 1.64 kPa (12.3 mmHg), and by pancuronium 0.015 mg/kg b.w. from 1.90 kPa (14.3 mmHg) to 1.44 kPa (10.8 mmHg). The decreases lasted for 7 min. Gallamine 0.3 mg/kg b.w. also decreased intraocular pressure, but to a lesser degree, and with statistical significance only during the fourth minute after administration. Relaxation of extraocular muscles may change the slightly ovoid shape of the eyeball into a more spherical one, thereby inducing a fall in intraocular pressure and a recession of the near point of accommodation.

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“…Administration of suxamethonium is often associated with an increase in intra‐ocular pressure [1–3], although the exact mechanism for this effect remains unclear. It has previously been suggested that the increase in intra‐ocular pressure after suxamethonium may be secondary to a sudden increase in arterial pressure [11], straining [12] or reflex venospasm [13]. However, contraction of the extra‐ocular muscles [14] and dilatation of choroidal blood vessels [15] may also play important roles.…”

Section: Discussionmentioning

confidence: 99%

The effect of mivacurium pretreatment on intra‐ocular pressure changes induced by suxamethonium

et al. 1998

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SummaryWe have evaluated the effects of the volume and speed of administration of local anaesthetic during peribulbar anaesthesia. One hundred and forty patients scheduled for cataract surgery were randomly allocated to one of four groups of 35. Each patient received an injection of the same mixture of lignocaine, bupivacaine and hyaluronidase. Patients in group A were given 9 ml at a speed of 5 ml.min À1 , group B were given the same volume at 12 ml.min À1 , group C were given 13.5 ml at 5 ml.min À1 and group D were given 13.5 ml at 12 ml.min À1 . A significantly higher incidence of satisfactory akinesia was found in group D, whose pain score at injection was no higher than for the other groups. Large volumes of local anaesthetic significantly affected intraocular pressure. The incidences of early and late ptosis or diplopia were not affected by either the rate of injection or the volume of local anaesthetic.

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An Evaluation SUCCINYLCHOLINE AND GALLAMINE AS MUSCLE RELAXANTS in relation to intraocular tension

Cited by 9 publications

References 0 publications

Intraocular pressure following pancuronium

Intraocular pressure following pancuronium

Some Aspects of Ocular Function after Precurarization

The effect of mivacurium pretreatment on intra‐ocular pressure changes induced by suxamethonium

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