Sayar Ali Caner, Deligoz Ozlem, Subasi Ferhunde Dilek, Imamoglu Serhat, Ekinci Osman
Department of Anesthesiology and Reanimation, University of Health Sciences Turkey, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey.
Department of Ophthalmology, University of Health Sciences Turkey, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey.
Beyoglu Eye J. 2022 May 27;7(2):77-82. doi: 10.14744/bej.2022.79037. eCollection 2022.
An increased reflex in sympathetic and sympathoadrenal activity caused by tracheal intubation causes an increase in arterial blood pressure, and increased venous pressure causes an increase in intraocular pressure (IOP). The aim of the current study was to compare the effects of lidocaine, fentanyl, and remifentanil to determine which agent was most effective in the prevention of elevated IOP.
The patients were separated into 3 groups (lidocaine, fentanyl, and remifentanil). Heart rate and mean arterial pressure (MAP) were measured and recorded 2 min after the administration of the drugs and at 1, 5, and 10 min after intubation. IOP was measured and recorded in each eye separately by an ophthalmologist preoperatively, at 2 min after drug administration and at 1, 5, and 10 min after intubation.
MAP was found to be high (122.750±17.068) in the lidocaine group at 1 min after intubation. In all 3 groups, the right and left eye IOP values were found to be higher at 1 min after intubation than at 2 min after drug administration. Only the difference in the lidocaine group was statistically significant (p=0.003). In all 3 groups, the right and left eye IOP values at 5 min after intubation were statistically significantly lower than the values at 1 min after intubation (Group 1: p=0.001, Group 2: p=0.000, and Group 3: p=0.000).
From the results of this study, it was concluded that remifentanil and fentanyl were more effective drugs than lidocaine in the prevention of increased IOP and hemodynamic response to intubation, and there was no significant difference between these two drugs.
气管插管引起的交感神经和交感肾上腺活动反射增强会导致动脉血压升高，静脉压升高会导致眼压（IOP）升高。本研究的目的是比较利多卡因、芬太尼和瑞芬太尼的效果，以确定哪种药物在预防眼压升高方面最有效。
将患者分为3组（利多卡因、芬太尼和瑞芬太尼）。给药后2分钟以及插管后1、5和10分钟测量并记录心率和平均动脉压（MAP）。术前、给药后2分钟以及插管后1、5和10分钟，由眼科医生分别测量并记录每只眼睛的眼压。
利多卡因组在插管后1分钟时MAP较高（122.750±17.068）。在所有3组中，发现插管后1分钟时左右眼眼压值高于给药后2分钟时。仅利多卡因组的差异具有统计学意义（p = 0.003）。在所有3组中，插管后5分钟时左右眼眼压值在统计学上显著低于插管后1分钟时的值（第1组：p = （此处原文似乎有误，推测应为0.001），第2组：p = 0.000，第3组：p = 0.000）。
从本研究结果得出结论，在预防眼压升高和插管引起的血流动力学反应方面，瑞芬太尼和芬太尼比利多卡因更有效，且这两种药物之间无显著差异。
