Abstract
The effects of atracurium 0.5 mg·kg-1l or succinylcholine 1.0 mg·kg-1 on intraocular pressure (IOP) were studied in ten patients during steady state nitrous oxide-oxygen-fentanyl anaesthesia. IOP was unchanged following atracurium but, one minute after succinylcholine, it had increased significantly (p < 0.025) from 5.6 mmHg to 13.2 mmHg and remained significantly above control for 3 min. Twenty additional patients received either atracurium 0.75 mg·kg-1 or succinylcholine 1.0 mg·kg-1 as part of a rapid sequence induction, atracurium being administered prior to, and succinylcholine after, thiopentone. Intubating conditions were acceptable in all patients in both groups. Administration of thiopentone was associated with a significant (p < 0.025) decrease in IOP. Although IOP increased in both groups as a result of laryngoscopy and intubation (from 8.0 mmHg to 12 .1 mmHg in the atracurium Group andfrom 7.5 mmHg to 14.5 mmHg in the succinylcholine group) it did not exceed pre-induction IOP in the former. In the succinylcholine group, IOP after intubation exceeded pre-induction values for 2 min, although this increase was significant (p < 0.05) only at the immediate post-intubation reading. It is concluded that atracurium in a dose of 0.75 mg·kg-1 is a suitable relaxant for use in rapid sequence induction.
Résumé
Les effets de 0.5 mg·kg-1 d’atracurium ou de succinylcholine 1.0 mg·kg-1 sur la pression intraoculaire (IOP) ont été étudiés chez les patients lors d’une anesthésie stable au protoxyde d’ azote-oxygène-fentanyl. La IOP a été inchangée suite à l’administration d’atracurium mais après une minute de l’administration de succinylcholine elle augmenta significativement (p < 0.025) de 5.6 mmHg à 13.2 mmHg et demeura significativement supeérieure au contrôle après 3 minutes. 20 patients additionnels ont reçu soit de l’atracurium 0.75 mg·kg-1 ou du succinylcholine 1.0 mg·kg-1 lors d’une induction à séquence rapide; l’atracurium étant administré avant et la succinylcholine après, thiopentone. Les conditions d’intubation étaient acceptables chez tous les patients des deux groupes. L’administration de thiopentone était associée avec une diminution significative de l’IOP (p < 0.025). Même si la IOP a augmenté dans les deux groupes suite à la laryngoscopie et l’intubation (de 8.0 mmHg a 12.1 mmHg pour le groupe atracurium et de 7.5 mmHg à 14.5 mmHg pour le groupe succinylcholine) elle n’a pas surpassé la valeur pré-induction pour le groupe atracurium. Dans le groupe succinylcholine la IOP apres intubation a excédé les valeurs pré-inductions pour deux minutes, même si cette augmentation n’était significative (p < 0.05) qu’immédiatement après l’intubation. Il est conclut que l’atracurium à des doses de 0.75 mg·kg-1 est une bloqueur neuromusculaire convenable pour l’utilisation lors d’induction a sequence rapide.
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Lavery, G.G., McGalliard, J.N., Mirakhur, R.K. et al. The effects of atracurium on intraocular pressure during steady state anaesthesia and rapid sequence induction: a comparison with succinylcholine. Can Anaesth Soc J 33, 437–442 (1986). https://doi.org/10.1007/BF03010968
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DOI: https://doi.org/10.1007/BF03010968