Majallah-i Dānishgāh-i ̒Ulūm-i Pizishkī-i Bābul (Jan 2009)

EFFECT OF SUBLINGUAL NIFEDIPINE ON INTRAOCULAR PRESSURE FOLLOWING ENDOTRACHEAL INTUBATION AND ADMINISTRATION OF SUCCINYLCHOLINE

  • P Amri,,
  • SM Rabiee,,
  • A Soleimani,,
  • A.GH Ghasemi,,
  • M Hoseinpour,
  • A Bijani

Journal volume & issue
Vol. 10, no. 6
pp. 36 – 41

Abstract

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BACKGROUND AND OBJECTIVE: One of the most important purposes in emergency anesthesia in patients undergoing ophthalmic surgery is prevention of gastric content aspiration and increase in intraocular pressure (IOP) during endotracheal intubation. Priority in prevention of gastric content aspiration necessitates use of rapid intubation technique by succinylcholine. The aim of this study was to evaluate the effect of nifedipine on intraocular pressure following endothracheal intubation after administration of succinylcholine.METHODS: In a clinical trial study, 64 patients aged 15-60 years old (ASA class I) were candidated for non ophthalmic surgery. They were randomly divided into two equal groups. Anesthetic technique was similar in both groups. In case group, 10mg sublingual nifedipine was administered 20 minutes before induction and in control group 10 drops of placebo were administered. IOP was measured by schiotz tonometer just before nifedipine and placebo administration and at 1, 3 and 5 minutes after induction.FINDINGS: In this study, mean IOP before induction was 12.5±2.8 and 13.9±3.2 mmHg in nifedipine and control group, respectively that this difference was not statistically significant. Mean IOP at 1, 3 and 5 minutes was 13.3±2.9, 14.3±3.2 and 11.6±2.9 mmHg in nifedipine group and also 17.9±3.5, 21.5±3.5 and 16.9±3.2 mmHg in control group, respectively (p<0.001). Also, ranges of IOP changes in two groups were meaningful (p<0.001). But no difference was seen in systolic blood pressure and heart rate alteration between two groups.CONCLUSION: According to the results of this study, increase in IOP caused by endothracheal intubation with succinylcholine after administration of sublingual nifedipine was very low. Therefore this method with rapid sequence induction and endothracheal intubation can be used in cases that significant changes in IOP are dangerous for ophthalmic procedures (e.g., penetrating eye injury).

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