title: The effects of remifentanil and esmolol on increase in intraocular pressure due to laryngoscopy and tracheal intubation: a double-blind, randomized clinical trial.
abstract: OBJECTIVE
  This study aimed to compare the effects of remifentanil and esmolol on the elevation of intraocular pressure (IOP) and hemodynamic response.
  
  
  METHODS
  After approval of the institutional Ethics Committee and obtaining informed consent, 60 adult patients with American Society of Anesthesiologists I-II status undergoing elective, nonophthalmic surgery were included in the study. Exclusion criteria were preexisting eye disease, neuromuscular disease, esophageal reflux, hiatus hernia, allergy to any of the study drugs, and the use of β-blockers, diuretics, or other antihypertensive agents. The patients were randomized into 2 groups by using the sealed-envelope method, as follows: group E (esmolol) and group R (remifentanil). A single intravenous dose of esmolol (0.5 mg/kg) or remifentanil (1 μg/kg) just before induction agents were given to patients in groups E and R, respectively. IOP, heart rate (HR), and mean arterial pressure (MAP) values were recorded before intubation and at 1, 3, 5, and 10 minutes after intubation.
  
  
  RESULTS
  The IOP decrease in group R was statistically significant compared with group E (P<0.01). HR values at 10 minutes after intubation were significantly decreased in group E compared with group R (P<0.05). There was no significant difference in MAP values between the groups.
  
  
  CONCLUSIONS
  It was concluded that remifentanil is more effective than esmolol in preventing IOP elevation related to laryngoscopy and tracheal intubation, while there is no significant difference between the 2 agents in terms of HR and MAP.
authors.affiliation: Departments of *Anesthesiology and Reanimation †Ophthalmology, Medical Faculty, Mustafa Kemal University, Hatay, Turkey.
authors.forename: Kasim
authors.initials: K
authors.lastname: Tuzcu
authors.forename: Esra A
authors.initials: EA
authors.lastname: Tuzcu
authors.forename: Murat
authors.initials: M
authors.lastname: Karcioglu
authors.forename: Isil
authors.initials: I
authors.lastname: Davarci
authors.forename: Mesut
authors.initials: M
authors.lastname: Coskun
authors.forename: Ozgur
authors.initials: O
authors.lastname: Ilhan
authors.forename: Mutlu C
authors.initials: MC
authors.lastname: Daglıoglu
authors.forename: Selim
authors.initials: S
authors.lastname: Turhanoglu
mesh_terms: D000293:Adolescent; D058671:Adrenergic beta-1 Receptor Antagonists / Q000494:pharmacology*; D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006439:Hemodynamics; D006801:Humans; D007275:Injections, Intravenous; D007429:Intraocular Pressure / Q000187:drug effects*; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D007828:Laryngoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000209:etiology / Q000517:prevention & control; D010880:Piperidines / Q000494:pharmacology*; D011412:Propanolamines / Q000494:pharmacology*; D017450:Receptors, Opioid, mu / Q000819:agonists*; D000077208:Remifentanil; D014065:Tonometry, Ocular
chemical_list: D058671:Adrenergic beta-1 Receptor Antagonists; D010880:Piperidines; D011412:Propanolamines; D017450:Receptors, Opioid, mu; C036604:esmolol; D000077208:Remifentanil