Pal Chandan Kumar, Ray Manjushree, Sen Anjana, Hajra Bimal, Mukherjee Dipankar, Ghanta Anil Kumar
Department of Anaesthesiology, N R S Medical College, Kolkata, West Bengal, India.
Indian J Anaesth. 2011 Nov;55(6):573-7. doi: 10.4103/0019-5049.90611.
Use of suxamethonium is associated with an increase in intraocular pressure (IOP) and may be harmful for patients with penetrating eye injuries. The purpose of our study was to observe the efficacy of dexmedetomidine for prevention of rise in IOP associated with the administration of suxamethonium and endotracheal intubation.
Sixty-six American Society of Anaesthesiologists I or II patients undergoing general anaesthesia for non-ophthalmic surgery were included in this randomized, prospective, clinical study. Patients were allocated into three groups to receive 0.4 μg/kg dexmedetomidine (group D4), 0.6 μg/kg dexmedetomidine (group D6) or normal saline (group C) over a period of 10 min before induction. IOP, heart rate and mean arterial pressure were recorded before and after the premedication, after induction, after suxamethonium injection and after endotracheal intubation.
Fall in IOP was observed following administration of dexmedetomidine. IOP increased in all three groups after suxamethonium injection and endotracheal intubation, but it never crossed the baseline value in group D4 as well as in group D6. Fall in mean arterial pressure was noticed after dexmedetomidine infusion, especially in the D6 group.
Dexmedetomidine (0.6 μg/kg as well as 0.4 μg/kg body weight) effectively prevents rise of IOP associated with administration of suxamethonium and endotracheal intubation. However, dexmedetomidine 0.6 μg/kg may cause significant hypotension. Thus, dexmedetomidine 0.4 μg/kg may be preferred for prevention of rise in IOP.
使用琥珀胆碱与眼内压(IOP)升高有关,可能对视穿通伤患者有害。我们研究的目的是观察右美托咪定预防与琥珀胆碱给药及气管插管相关的IOP升高的疗效。
本随机、前瞻性临床研究纳入了66例接受非眼科手术全身麻醉的美国麻醉医师协会I或II级患者。患者被分为三组,在诱导前10分钟内分别接受0.4μg/kg右美托咪定(D4组)、0.6μg/kg右美托咪定(D6组)或生理盐水(C组)。记录术前用药前、诱导后、琥珀胆碱注射后及气管插管后的IOP、心率和平均动脉压。
右美托咪定给药后观察到IOP下降。琥珀胆碱注射和气管插管后所有三组的IOP均升高,但D4组和D6组的IOP从未超过基线值。右美托咪定输注后观察到平均动脉压下降,尤其是在D6组。
右美托咪定(0.6μg/kg以及0.4μg/kg体重)能有效预防与琥珀胆碱给药及气管插管相关的IOP升高。然而,0.6μg/kg右美托咪定可能导致显著低血压。因此,0.4μg/kg右美托咪定可能更适合用于预防IOP升高。