title: Efficacy of alpha2 agonists in obtunding rise in intraocular pressure after succinylcholine and that following laryngoscopy and intubation.
abstract: BACKGROUND
  Elevation of intraocular pressure (IOP) is an inherent and inadvertent association with the use of succinylcholine and alpha2 agonists can be used to obtund this effect.
  
  
  OBJECTIVE
  The study was aimed to assess the efficacy of intravenous dexmedetomidine and clonidine premedication in attenuating rise in IOP during laryngoscopy and intubation following administration of succinylcholine.
  
  
  METHODS
  This prospective, observational study was conducted in 40 patients aged 20-60 years undergoing non ophthalmic surgical procedures.
  
  
  METHODS
  For patients in Group D, dexmedetomidine 0.4 mcg/kg and in Group C clonidine 1 μg/kg over 10 min was administered before induction. All patients were induced with propofol. Laryngoscopy and intubation were performed 1 min after administration of succinylcholine 2 mg/kg.
  
  
  METHODS
  Mann-Whitney, Chi-square and Wilcoxon tests.
  
  
  RESULTS
  Mean baseline IOP of both groups were comparable (15.4 ± 2.6 vs. 14.7 ± 2.3). Following premedication and induction, IOP decreased in both groups and the reduction was significantly more in Group D. Following administration of succinylcholine and 1 min after intubation IOP raised and exceeded the baseline value in Group C (16.0 ± 1.6 and 18.6 ± 2.2). Though there was an increase in IOP in Group D (12.0 ± 1.9 and 14.0 ± 2.1), it did not reach up to baseline values. Then there was a gradual reduction in IOP in both groups at 3, 5, and 10 min and Group D continued to have a significantly low IOP than Group C up to 10 min.
  
  
  CONCLUSIONS
  Dexmedetomidine 0.4 μg/kg resulted in a reduction of IOP and blunted the increase in IOP, which followed administration of succinylcholine, laryngoscopy, and intubation. Though clonidine 1 μg/kg reduced IOP, it did not prevent rise in IOP following succinylcholine, laryngoscopy, and intubation.
authors.affiliation: Department of Anaesthesiology, Amrita Institute of Medical Sciences, Kochi, India.
authors.forename: Sunil
authors.initials: S
authors.lastname: Rajan
authors.affiliation: Department of Ophthalmology, Government Medical College, Kottayam, Kerala, India.
authors.forename: Saritha Valsala
authors.initials: SV
authors.lastname: Krishnankutty
authors.affiliation: Department of Ophthalmology, Amrita Institute of Medical Sciences, Kochi, India.
authors.forename: Hema Muraleedharan
authors.initials: HM
authors.lastname: Nair
keywords: Clonidine; dexmedetomidine; intraocular pressure; intubation; laryngoscopy; succinylcholine