Effect of intravenous metoclopramide on intraocular pressure: a prospective, randomized, double-blind, placebo-controlled study.
BACKGROUND
Prevention of rise in intraocular pressure (IOP) is essential in patients undergoing surgery for perforated eye injuries. Metoclopramide, a prokinetic agent, is commonly used to hasten gastric emptying in emergency surgeries.


OBJECTIVE
To study the change in IOP after intravenous metoclopramide and to study the influence of metoclopramide on change in IOP after succinylcholine and tracheal intubation.


METHODS
A randomized, double-blind, placebo-controlled study of 60 patients undergoing non-ophthalmic elective surgery.


METHODS
Sixty American Society of Anesthesiologists (ASA) I adult patients were randomly assigned to receive normal saline (Group C) or metoclopramide 10 mg (Group M) 30 min before the induction of anesthesia. Thiopentone was used for induction and succinylcholine for tracheal intubation. Intraocular pressure was measured in both the eyes pre and post drug treatment and succinylcholine and tracheal intubation using Perkins applanation tonometer.


METHODS
Student's t-test and repeated measures ANOVA were used. A P value < 0.05 was considered as significant.


RESULTS
Intraocular pressure was consistently lower in Group M than in Group C after the test drug, though the difference was not statistically significant. Intraocular pressure decreased significantly after administration of thiopentone and increased significantly in Groups C and M after tracheal intubation (P<0.01). Intraocular pressure was comparable between the groups at all the times.


CONCLUSIONS
Metoclopramide does not cause a clinically significant change in IOP nor does it influence the changes in IOP during anesthesia and tracheal intubation. Metoclopramide shows a trend towards decrease in IOP, though clinically insignificant. Therefore metoclopramide can be used to promote gastric emptying in patients with perforated eye injury.
Sudheera
K S
KS
Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India. sudheeraks@gmail.com
Bhardwaj
N
N
Yaddanapudi
S
S
D000328:Adult; D000704:Analysis of Variance; D018686:Anesthetics, Intravenous / Q000494:pharmacology; D018492:Dopamine Antagonists / Q000008:administration & dosage / Q000494:pharmacology*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007429:Intraocular Pressure / Q000187:drug effects*; D007442:Intubation, Intratracheal; D008297:Male; D008787:Metoclopramide / Q000008:administration & dosage / Q000494:pharmacology*; D008875:Middle Aged; D009467:Neuromuscular Depolarizing Agents / Q000494:pharmacology; D011446:Prospective Studies; D013390:Succinylcholine / Q000494:pharmacology; D013874:Thiopental / Q000494:pharmacology; D014065:Tonometry, Ocular
D018686:Anesthetics, Intravenous; D018492:Dopamine Antagonists; D009467:Neuromuscular Depolarizing Agents; D013390:Succinylcholine; D013874:Thiopental; D008787:Metoclopramide