Intra‐ocular pressure and premedication with oral diazepam

Abstract

SummaryThirty patients wheduled for routine eye surgery were randomly allocated to receive either diazepam 0.2 mglkg or ascorbic acid 100 mg orully 90 minuies pre-operutively in CI double-blind fashion. Diaiepam caused no signiJcant change in intra-ocular pressure. Key wordsPremedicution; diazepam. Measurement; intra-ocular pressure.The effect of anaesthetic drugs on the eye has recently been reviewed.l Diazepam is a useful premedicant for eye surgery as it reduces anxiety without causing nausea.2 Given parenterally diazepam may cause a decrease in intra-ocular p r e s s~~,~ but the effect of oral diazepam on intra-ocular pressure has not previously been reported. This paper presents the results of such a study. MethodsStudies were carried out on 30 patients over 20 years of age scheduled for eye surgery all of whom gave informed consent. The patients were randomly allocated to receive either ascorbic acid 100 mg or diazepam 0.2 mg/kg orally 90 minutes pre-operatively, Before premedication intra-ocular pressure was measured in the normal eye in the supine position using the hand held Perkins Applanation Tonometer4 after instillation of oxybuprocaine drops. Arterial blood pressure was also recorded in the supine position from the right arm by the auscultatory method. These observations were repeated prior to induction. ResultsThe results obtained in the patients who received diazepam are shown in Table 1 and the placebo in Table 2. The mean change in intra-ocular pressure in the diazepam group was -0.35 mmHg (SD 2.7), and in the ascorbic acid group was 0.46 mmHg (SD 4.8). The difference between the two groups was not statistically different (unpaired 'I' test). Furthermore there was no correlation between intra-ocular pressure and either the systolic or diastolic arterial pressures (r = 0.15 and 0.27, respectively). DiscussionThese results indicate that diazepam 0.2 mgjkg orally can be given safely to patients for eye surgery in whom changes in intra-ocular pressure may be undesirable. It was not expected that the arterial pressure would alter the intra-ocular pressure since gradual changes within the physiological range are known to have little effect.'

Alfentanil/promazine versus meperidine/promazine as a sedative regimens during local analgesia for cataract operation

“…As IOP can vary by up to 3 mm Hg under normal condition and this small drop correlates with previous studies on the effect of premedication on IOP [16,17], but may also be due to diurnal IOP variation. This study demonstrates that IV sedation provokes significant decrease in lOP in both groups after IV sedation, but the decrease was much greater in the Alfentanil group than in the Meperidine group.…”

Oftalmik cerrahide anestezi

“…Premedikasyonda kullanılan ilaçlar (benzodiazepinler gibi) GİB'de değişiklik oluşturmazlar, anksiyetenin azaltılması amacıyla özellikle lokal anestezi uygulanacak olgularda önemlidir (31,32). Yaşlı hastalarda premedikasyonda operasyondan önceki gece ve operasyondan iki saat önce oral alınan gabapentin çalışılmış preoperatif anksiyeteyi etkin şekilde azalttığı gösterilmiştir (33,34).…”

The effect of atracurium or fazadinium on intra‐ocular pressure. A comparative study during induction of general anaesthesia

“…Premedication waswithdiazepam0.3 mg/kg (to a maximum of 20 mg) given orally 2 hours preoperatively. 4 In the anaesthetic room the pulse and blood pressure were simultaneously recorded using a Sentron automatic blood pressure monitor (Bard Biomedical), and the ECG monitored with leadsin the CM5 configuration. Theeye which wasnot to undergo surgery was anaesthetised with two drops of I % amethocaine and dyed with fluorescein.…”