Effect of remifentanil compared with fentanyl on intraocular pressure after succinylcholine and tracheal intubation.
Rapid sequence induction using succinylcholine is associated with an increase in intraocular pressure (IOP). This may lead to loss of ocular contents in open globe injuries. No method has previously been shown to prevent this increase in IOP. We investigated whether remifentanil, an ultra-short-acting opioid, could attenuate this increase in IOP during rapid sequence induction of anaesthesia. Forty-five patients were randomized blindly to receive remifentanil 1 microgram kg-1, fentanyl 2 micrograms kg-1 or placebo 1 min before thiopental, succinylcholine and tracheal intubation. IOP and haemodynamic variables were measured before, 1 min after the test solution, 30 s after thiopental, 30 s after succinylcholine, immediately after intubation and then every 3 min for 9 min. Remifentanil obtunded the increase in IOP after succinylcholine and intubation, so it could be suitable for use in open globe injuries.
Ng
H P
HP
Department of Anaesthesia, National University Hospital, Singapore, Singapore.
Chen
F G
FG
Yeong
S M
SM
Wong
E
E
Chew
P
P
D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000627:therapeutic use; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009467:Neuromuscular Depolarizing Agents / Q000009:adverse effects*; D009798:Ocular Hypertension / Q000209:etiology / Q000517:prevention & control*; D010880:Piperidines / Q000627:therapeutic use*; D000077208:Remifentanil; D013390:Succinylcholine / Q000009:adverse effects*
D000701:Analgesics, Opioid; D009467:Neuromuscular Depolarizing Agents; D010880:Piperidines; D013390:Succinylcholine; D000077208:Remifentanil; D005283:Fentanyl