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BJA Advance Access originally published online on February 19, 2008
British Journal of Anaesthesia 2008 100(4):485-489; doi:10.1093/bja/aen020
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2008. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Effect of dexmedetomidine premedication on the intraocular pressure changes after succinylcholine and intubation

H. A. Mowafi1,*, N. Aldossary1, S. A. Ismail1 and J. Alqahtani2

1 Department of Anaesthesiology
2 Department of Ophthalmology, Faculty of Medicine, King Faisal University, Saudi Arabia

* Corresponding author: Department of Anaesthesiology, King Fahd University Hospital, PO Box 40081, Al-Khobar 31952, Saudi Arabia. E-mail: hany_mowafi{at}hotmail.com

Background: Succinylcholine is still recommended for some situations in open globe injuries. However, the use of succinylcholine is associated with an increase in intraocular pressure (IOP). This may be deleterious in open globe injuries. No method has previously been shown to abolish completely this rise in the IOP. We investigated whether dexmedetomidine, an alpha-2 agonist, could attenuate this increase in the IOP after succinylcholine and intubation.

Methods: Forty patients with no pre-existing eye disease undergoing general anaesthesia were randomly premedicated by i.v. dexmedetomidine 0.6 µg kg–1, or saline. Heart rate (HR), mean arterial pressure (MAP), and IOP (using Schioetz tonometer) were measured before, after the premedication, after thiopental, after succinylcholine, immediately after intubation, and then every 2 min for 6 min.

Results: Succinylcholine and intubation increased IOP in both groups. However, in the dexmedetomidine group, the IOP rise was not different from the baseline value (P=0.65) and was significantly lower than in the saline group (P=0.003). After intubation, the MAP in the control group was higher than that in the dexmedetomidine group (P=0.041) and exceeded the baseline value (P<0.001). The HR also showed less fluctuation in the dexmedetomidine group than in the saline group.

Conclusions: We conclude that dexmedetomidine could be a beneficial premedication in open globe injuries.

Keywords: anaesthesia, general; eye, intraocular pressure; neuromuscular block, succinylcholine; pharmacology, dexmedetomidine


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This article has been cited by other articles:


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 Br J AnaesthHome page
J. Robin, R. Alexander, H. A. Mowafi, N. Aldossary, S. A. Ismail, and J. Alqahtani
Remifentanil obtunds intraocular pressure rises associated with suxamethonium
Br. J. Anaesth., September 1, 2008; 101(3): 432 - 433.
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Remifentanil obtunds intraocular pressure rises associated with suxamethonium.
Julie I Robin, et al.
British Journal of Anaesthesia, 19 Jun 2008 [Full text]
In Response:
Hany A. Mowafi, et al.
British Journal of Anaesthesia, 29 Jun 2008 [Full text]

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