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Canadian Journal of Anesthesia, Vol 33, 437-442, Copyright © 1986 by Canadian Anesthesiologists' Society

The Effects of Atracurium On Intraocular Pressure During Steady State Anaesthesia and Rapid Sequence Induction: A Comparison With Succinylcholine

GAVIN G. LAVERY FFARCS1, JAMES N. McGALLIARD MB BCH1, RAJINDER K. MIRAKHUR MD PHD FFARCS FFARCSI1, and WILLIAM F. I. SHEPHERD FRCS1

1 Department of Anaesthetics and Ophthalmology, Queen's University and Royal Victoria Hospital, Belfast, Northern Ireland

Address correspondence to: Dr R.K. Mirakhur, Department of Clinical Anaesthesia, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BA, Northern Ireland.

The effects of atracurium 0.5 mg·kg-1 or succinylcholine 1.0 mg·kg-1 on intraocular pressure (IOP) were studied in ten patients during steady state nitrous oxide-oxygenfentanyl 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. lntubating 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 and from 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 postintubation 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.

Key Words: NEUROMUSCULAR RELAXANTS: atracurium, succinylcholine • EYE: intraocular pressure • ANAESTHETIC TECHNIQUES: rapid sequence induction






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Copyright © 1986 by the Canadian Anesthesiologists' Society.