Sudheera K S, Bhardwaj N, Yaddanapudi S
Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
J Postgrad Med. 2008 Jul-Sep;54(3):195-8. doi: 10.4103/0022-3859.41800.
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.
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.
A randomized, double-blind, placebo-controlled study of 60 patients undergoing non-ophthalmic elective surgery.
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.
Student's t-test and repeated measures ANOVA were used. A P value < 0.05 was considered as significant.
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.
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.
对于接受眼球穿孔伤手术的患者，预防眼压升高至关重要。甲氧氯普胺是一种促动力药物，常用于急诊手术中加速胃排空。
研究静脉注射甲氧氯普胺后眼压的变化，并研究甲氧氯普胺对琥珀胆碱和气管插管后眼压变化的影响。
一项对60例接受非眼科择期手术患者的随机、双盲、安慰剂对照研究。
60例美国麻醉医师协会（ASA）I级成年患者在麻醉诱导前30分钟随机分为两组，分别接受生理盐水（C组）或10毫克甲氧氯普胺（M组）。采用硫喷妥钠诱导麻醉，琥珀胆碱用于气管插管。使用珀金氏压平眼压计在用药前、用药后以及琥珀胆碱和气管插管前后测量双眼眼压。
采用学生t检验和重复测量方差分析。P值<0.05被认为具有统计学意义。
给药后，M组眼压始终低于C组，尽管差异无统计学意义。硫喷妥钠给药后眼压显著下降，气管插管后C组和M组眼压显著升高（P<0.01）。两组在所有时间点的眼压均具有可比性。
甲氧氯普胺不会引起临床上显著的眼压变化，也不会影响麻醉和气管插管期间的眼压变化。甲氧氯普胺虽有使眼压降低的趋势，但临床上无显著意义。因此，甲氧氯普胺可用于促进眼球穿孔伤患者的胃排空。
