Effect of different doses of cisatracurium on intraocular pressure in sedated patients.
OBJECTIVE
The aim was to examine the course of intraocular pressure after relaxation with different doses of cisatracurium.


METHODS
The investigation was carried out as a prospective, randomized double-blind study in a crossover design in 30 postoperative patients with stable haemodynamic and respiratory function (ASA I and II). To exclude any disrupting factors, patients remained intubated and continuously sedated. Twenty patients received an intubation dose (2 x ED95) of cisatracurium (0.1 mg kg(-1)) compared with atracurium (0.5 mg kg(-1)). In a second series, 10 patients were given an effective dose, ED95 (0.05 mg kg(-1)), and a repeat dose (0.02 mg kg(-1)) of cisatracurium. The intraocular pressure was determined before (T0) as well as 1 (T1), 5 (T5), 10 (T10), 15 (T15), 20 (T20) and 45 (T45) min after bolus administration.


RESULTS
Intraocular pressure decreased after an intubation dose of either cisatracurium or atracurium, and reached a minimum after 10 min (6.7 +/- 2.2 and 7.9 +/- 2.1 mmHg, respectively). There was no significant difference between either muscle relaxant (P = 0.27). When lower doses of cisatracurium (0.05 and 0.02 mg kg(-1)) were applied, the intraocular pressure also decreased, albeit to a lesser extent and with a delayed onset (8.4 +/- 1.9 mmHg after 10 min, 9.9 +/- 3.4 mmHg after 15 min). There was no significant difference between dosages (p = 0.44).


CONCLUSIONS
Cisatracurium is a useful drug in patients when a decrease of intraocular pressure is wanted and where muscle relaxation is necessary and acceptable.
Sator-Katzenschlager
S M
SM
University of Vienna, Department of Anaesthesiology and General Intensive Care (B), Austria.
Oehmke
M J
MJ
Kontaratos
M
M
Wedrich
A
A
Heinze
G
G
Weinstabl
C
C
D001279:Atracurium / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology*; D002245:Carbon Dioxide / Q000097:blood; D016292:Procedural Sedation; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage / Q000494:pharmacology*; D010100:Oxygen / Q000097:blood; D011446:Prospective Studies
D003473:Neuromuscular Nondepolarizing Agents; D002245:Carbon Dioxide; D001279:Atracurium; C101584:cisatracurium; D010100:Oxygen