Comparative evaluation of effect of vecuronium and succinylcholine on intraocular pressure

Abstract

Background and Aim: The success of ophthalmic surgery, particularly when the globe is opened, depends to large extent on good control of intraocular pressure not only at induction of anesthesia, but also during maintenance phase. Intubation is usually achieved with the use of non-depolarizing muscle relaxants for fear of increasing intraocular pressure with depolarizing relaxants. Present study was undertaken with an aim to evaluate the effect of succinylcholine or vecuronium on intraocular pressure in association with propofol induction.
Methodology: Fifty patients of both sexes of ASA physical status I and II, between 15-50 years of age were selected for the study for one year. Patients with clinically significant pre-existing eye disease, raised base line IOP, cardiorespiratory illness, CNS diseases, difficult airway, obesity, those receiving any drug likely to have an effect on IOP and in whom use of succinylcholine was contraindicated were excluded. Patients were randomly assigned to two equal groups. Anesthesia was induced by propofol 2 mg/kg over 30 sec in all patients. In Group V patients we used vecuronium and in Group S used succinylcholine for intubation. Statistical analysis was done with one way ANOVA using SPSS software version 15.

Results: In Group V, 28.49% decrease in IOP after induction and one min after intubation IOP was increase to 14.53% but it remain still lower than the baseline value. In Group S, there was 28.14% increase in IOP after induction and one min after intubation IOP was increase to 35.56%. Significant increase in pulse rate and blood pressure noted in Group S after induction agent and intubation as compared to Group V.

Conclusion: Propofol + vecuronium provide good to excellent intubating condition and it is a suitable agent for tracheal intubation for patient undergoing elective and emergency ophthalmic surgery where rise in IOP is undesirable.