title: Intra-ocular pressure changes during rapid sequence induction of anaesthesia. A comparison between thiopentone and suxamethonium and thiopentone and atracurium.
abstract: The changes in intra-ocular pressure associated with two different anaesthetic induction and tracheal intubation techniques were compared (n = 30). After pre-oxygenation, Group A received thiopentone (5 mg/kg) followed by suxamethonium (1.5 mg/kg), both within 25 seconds, and Group B atracurium (0.5 mg/kg) followed by thiopentone (5 mg/kg) again both within 25 seconds. Tracheal intubation occurred after one minute in Group A and 2 minutes in Group B to allow for full paralysis. In Group A intra-ocular pressure did not alter significantly from baseline and the maximum increase was only 0.93 mmHg. The statistical type II error risk was consistently below 55% and all 95% confidence limits included negative values. Intra-ocular pressure in Group B was consistently lower than baseline (p less than 0.05) but with a longer induction-intubation interval. These results therefore provide valuable information about the 'balance of risks' when choosing a muscle relaxant for an inadequately starved patient with a penetrating eye injury.
authors.affiliation: Department of Anaesthesia, Whipps Cross Hospital, Leytonstone, London.
authors.forename: L
authors.initials: L
authors.lastname: Edmondson
authors.forename: S L
authors.initials: SL
authors.lastname: Lindsay
authors.forename: L P
authors.initials: LP
authors.lastname: Lanigan
authors.forename: M
authors.initials: M
authors.lastname: Woods
authors.forename: H E
authors.initials: HE
authors.lastname: Chew
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000771:Anesthesia, Intravenous; D001279:Atracurium / Q000494:pharmacology*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D007442:Intubation, Intratracheal; D008875:Middle Aged; D013223:Statistics as Topic; D013390:Succinylcholine / Q000494:pharmacology*; D013874:Thiopental / Q000494:pharmacology*; D013997:Time Factors
chemical_list: D001279:Atracurium; D013390:Succinylcholine; D013874:Thiopental