Precautions against intra-ocular pressure changes during endotracheal intubation--a comparison of pretreatment with intravenous lignocaine and diazepam.

Endotracheal intubation after administration of succinylcholine is associated with a rise in intraocular pressure (IOP). That this is likely to have harmful effects in patients with penetrating eye injuries is self-evident. The efficacy of various means of abolishing these effects is debatable. This study evaluates pretreatment with intravenous lignocaine and diazepam in the prevention of high IOP during a standard induction-intubation sequence. Sixty patients were randomly divided into a control group receiving pretreatment with saline and two study groups receiving pretreatment with lignocaine and diazepam respectively. IOP, pulse rate and systolic blood pressure were recorded after induction, after intubation and after return of spontaneous respiration. Statistical analysis of the data showed that diazepam diminished the rise in IOP, while lignocaine had little effect (P less than 0,05). It is concluded that pretreatment with diazepam 0,05 mg/kg is beneficial in reducing the ocular risks of endotracheal intubation.