Canadian Anaesthetists’ Society Journal

, Volume 26, Issue 6, pp 479–481

Effect of pancuronium on intraocular pressure changes induced by succinylcholine

  • Halappa N. Konchigeri
  • Yong Eun Lee
  • Kottarathil Venugopal
Article

Summary

The study was undertaken to evaluate the influence of pretreatment with a small dose of pancuronium on intraocular pressure changes associated with administration of succinylcholine and tracheal intubation. Thirty patients divided into control and study groups were anaesthetized with sodium thiopentone (3-5 mg · kg1) and intubation with the aid of succinylcholine (1 mg · kg-1).

The control group received saline pretreatment while the study group received pancuronium 1 mg three minutes before succinylcholine. Anaesthesia was maintained with nitrous oxide and oxygen (70:30). A Schiotz tonometer was used to measure intraocular pressure before induction of anaesthesia, one minute after succinylcholine and immediately after intubation.

Patients in the control group demonstrated significant elevation of intraocular pressure at one minute after succinylcholine and immediately after intubation, while the study group showed no significant changes at the same observation periods.

These findings indicate that pretreatment with pancuronium 1 mg three minutes before succinylcholine may be beneficial in patients with high intraocular pressure and penetrating injuries of the eye.

Résumé

Ľétude avait pour but ďévaluer ľinfluence du pré-traitement au pancuronium à petite dose sur les modifications de la tension intraoculaire provoquée par ľadministration de succinylcholine et par ľintubation de la trachée. Deux groupes de treize patients, dont un servait de contrôle, furent anesthésiés avec du thiopental 3-5 mg · kg-1 et intubés à ľaide de succinylcholine 0.1 mg é kg-1.

Le groupe de contrôle fut traité avec du soluté physiologique alors que le groupe ďétude reçut pancuronium 1.0 mg trois minutes avant ľadministration de succinylcholine. Ľanesthésie fut maintenue avec du protoxyde ďazote et ďoxygène (70:30) pendant la période ďétude. Un tonomètre de Schiotz fut employé pour mesurer la pression intraoculaire avant ľinduction, une minute après succinylcholine et finalement après ľintubation de la trachée.

Les patients du groupe de contrôle ont montré une élévation significative de la tension intraoculaire une minute après la succinylcholine et immédiatement après ľintubation trachéale, alors que le groupe ďétude n’a pas montré de changements significatifs de tension intraoculaire dans les mêmes périodes ďobservation. Ces observations semblent indiquer que le prétraitement au pancuronium I mg trois minute avant ľadministration de succinylcholine pourrait être bénéfique aux malades dont la tension intraoculaire est déjà élevée et aux victimes de plaies pénétrantes de ľœil.

References

  1. 1.
    Dillon, J.B., Sabawala, P., Taylor, D.B. &Gunter, R. Action of succinylcholine on extraocular muscles and Intraocular pressure. Anesthesiology18: 44 (1957).PubMedGoogle Scholar
  2. 2.
    Schwartz, H. &DeRaetth, A. Effect of succinylcholine on intraocular pressure in human beings. Anesthesiology19: 112(1958).CrossRefGoogle Scholar
  3. 3.
    Adams, A.K. &Barnett, K.C. Anaesthesia and intraocular pressure. Anaesthesia21: 202(1966).PubMedCrossRefGoogle Scholar
  4. 4.
    Wylie, W.D. &Churchill-Davidson, H.C. Neuromuscular blocking drugs, in: A Practice of Anaesthesia, 3rd ed.. Chicago, Year Book Medical Publishers. Inc. p. 857(1972).Google Scholar
  5. 5.
    Sobel, A.M. Hexafluorenium. succinylcholine and intraocular tension. Anesth. Analg.41: 399 (1962).PubMedCrossRefGoogle Scholar
  6. 6.
    Duncalf, D. &Foldes, F.F. Anesthesia in Ophthalmology, International Ophthalmology Clinics, Boston, Little Brown & Co., Vol. 32, No. 2, p. 21(1973).Google Scholar
  7. 7.
    Macri, F.J. &Grimes, P.A. The effect of succinylcholine on the extraocular striate muscles and on the intraocular pressure. Amer. J. Ophthal.44: 221(1957).PubMedGoogle Scholar
  8. 8.
    Miller, R.D., Way, W.L. &Hickey, R.F. Inhibition of succinylcholine induced increased intraocular pressure by non-depolarizing muscle relaxants. Anesthesiology29: 123(1968).PubMedCrossRefGoogle Scholar
  9. 9.
    Smith, R.B. &Leano, N. Intraocular pressures following pancuronium. Can. Anaesth. Soc. J.20: 742(1973).PubMedCrossRefGoogle Scholar
  10. 10.
    Litwiller, R.W., Difazio, C.A. &Rushia, E.L. Pancuronium and intraocular pressure. Anesthesiology42: 750 (1975).PubMedCrossRefGoogle Scholar
  11. 11.
    Bowen, D.J., McGrand, J.C. &Palmer, R.J. Intraocular pressures after suxamethonium and endotracheal intubation in patients pretreated with pancuronium. B.J. Anesth.48: 1201 (1976).CrossRefGoogle Scholar
  12. 12.
    Lincoff, H.A., Ellis, C.H., DeVoe, A.G., et al. The effect of Succinylcholine on intraocular pressure. Am. J. Ophthalmology40: 501 (1955).Google Scholar
  13. 13.
    Hess, A. &Pilar. G. Slow libres in the extraocular muscles of the Cal. J. Physiol (Lond.)169: 780 (1963).Google Scholar
  14. 14.
    Katz, R.L. &Eakins, K.E. The action of neuromuscular blocking agents on extraocular muscle and intraocular pressure. Proc. Roy, Soc. Med.62: 1217 (1969).Google Scholar
  15. 15.
    Duncalf, D. &Weitzner, S.W. The influence of ventilation and hypercapnia on intraocular pressure during anesthesia. Anesth. Analg.42: 232 (1963).CrossRefGoogle Scholar
  16. 16.
    Carballo, A.S. Succinylcholine and acetazolamide (Diamox) in anesthesia for ocular surgery. Canad. Anaesth. Soc. J.12: 486(1965).PubMedCrossRefGoogle Scholar

Copyright information

© Canadian Anesthesiologists 1979

Authors and Affiliations

  • Halappa N. Konchigeri
    • 1
  • Yong Eun Lee
    • 1
  • Kottarathil Venugopal
    • 1
  1. 1.Department of AnesthesiologyAbraham Lincoln School of Medicine, University of Illinois HospitalsChicagoU.S.A.
  2. 2.The International Anesthesia Research SocietySan Francisco

Personalised recommendations