Intraocular tension in association with succinylcholine and endotracheal intubation: a preliminary report

Wynands, J. Earl; Crowell, D. E.

doi:10.1007/bf03013681

Cited by 40 publications

(12 citation statements)

References 7 publications

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“…Therefore, it is important to know some of the purported mechanisms of the unpredictable and sometimes significant IOP elevations associated with endotracheal intubation. 63,177,187 Suggested explanations for IOP elevations with endotracheal intubation are as follows 1, 18,30,88,126,152 : 1) the actual stress of laryngoscopy and the passage of the endotracheal tube through the glottic aperture 30 can cause sympathetic stimulation, which can result in a rise in IOP, 1, 30,187 2) sympathetic stimulation may also affect vasoconstriction and increase central venous pressure, which can therefore increase IOP, 138,178 and 3) adrenergic stimulation may also increase resistance to aqueous humor outflow through the trabecular meshwork, resulting in a rise in IOP. 88 To compensate for potential IOP elevations associated with laryngoscopy and intubation, some studies suggest that the IOP elevation can be minimized with rocuronium, a muscle relaxant, 178 clonidine, 57,94 and dexmedetomidine premedication.…”

Section: Intubationmentioning

confidence: 99%

Pediatric intraocular pressure measurements: Tonometers, central corneal thickness, and anesthesia

Fayed

Chen

2019

Survey of Ophthalmology

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Measuring intraocular pressure (IOP) is the cornerstone of a comprehensive glaucoma examination. In babies or small children, however, IOP measurements are problematic, cannot often be performed at the slit lamp, and sometimes require general anesthesia. Therefore, it is essential for an ophthalmologist who examines a pediatric patient to be aware of the different tonometers used in children, as well as the effects of central corneal thickness and anesthesia on IOP measurements. Goldmann applanation tonometry is the gold standard for IOP assessment. Most alternative tonometers tend to give higher IOP readings than the Goldmann applanation tonometer, and readings between different tonometers are often not interchangeable. Similar to Goldmann tonometry, many of these alternative tonometers are affected by central corneal thickness, with thicker corneas having artifactually high IOP readings and thinner corneas having artifactually lower IOP readings. Although various machines can be used to compensate for corneal factors (e.g., the dynamic contour tonometer and ocular response analyzer), it is important to be aware that certain ocular diseases can be associated with abnormal central corneal thickness values and that their IOP readings need to be interpreted accordingly. Because induction and anesthetics can affect IOP, office IOPs taken in awake patients are always the most accurate.

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Section: Intubationmentioning

confidence: 99%

Pediatric intraocular pressure measurements: Tonometers, central corneal thickness, and anesthesia

Fayed

Chen

2019

Survey of Ophthalmology

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“…[7] Laryngoscopy-guided endotracheal intubation evokes rise in hemodynamic response and IOP. [12] We found stable hemodynamics to PLMA insertion (introducer tool technique). However, there was a significant rise in IOP with the use of PLMA though the rise was lesser than that with the use of an endotracheal tube.…”

Section: Discussionmentioning

confidence: 88%

“…[2] Classic laryngeal mask airway (LMA) has been found to be superior to tracheal intubation in terms of maintaining stable IOP,[3] but positive pressure ventilation could become a challenge in certain cases. Proseal laryngeal mask airway (PLMA) offers the advantage of providing a better seal in the oropharynx to allow ventilation at much higher pressure and a drain tube to protect the lungs from aspiration and stomach from gastric insufflation.…”

Section: Introductionmentioning

confidence: 99%

A randomized comparative study of intraocular pressure and hemodynamic changes on insertion of proseal laryngeal mask airway and conventional tracheal intubation in pediatric patients

Agrawal¹,

Agarwal²,

Taneja³

2012

J Anaesthesiol Clin Pharmacol

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Objective:To assess the influence of proseal laryngeal mask airway (PLMA) insertion on intraocular pressure (IOP).Aim:We compared the effects of PLMA insertion and laryngoscopic intubation on IOP and hemodynamic response in pediatric patients.Background:Previous studies have shown that there is no hemodynamic response to PLMA insertion similar to classic LMA insertion, but there is no published report about the influence of PLMA insertion on IOP. Conventional laryngoscopic tracheal intubation evokes a rise in IOP and cardiovascular response and has been traditionally used to secure the airway in pediatric patients undergoing ophthalmic surgery.Materials and Methods:59 patients, less than 14 years of age, scheduled for elective ophthalmic surgery were randomly divided into two groups, group P, in which the patient's airway was secured with PLMA (using introducer tool technique), and group T, in which the airway was secured with laryngoscopy-guided endotracheal intubation. Heart rate, blood pressure, and IOP were measured just before insertion of the airway device and subsequently three times at intervals of 1 min after insertion of the airway device.Results:In group T, there was a significant rise in IOP as well as hemodynamic parameters recorded. In group P, there was no significant rise in hemodynamic parameters, but a significant rise in IOP was found though the rise was less than in group T.Conclusion:We conclude that the PLMA use is associated with lesser cardiovascular response and rise in IOP as compared to tracheal intubation.

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“…1 and an increase in intraocular pressure. 2,3 These changes have been observed to be associated with increased catecholamine levels confirming a predominantly sympathetic response to it. The rise in IOP may be secondary to increased sympathetic activity causing vasoconstriction and an increase in central venous pressure, which has a closer relationship with intraocular pressure than systemic arterial pressure.…”

Section: Introductionmentioning

confidence: 89%

A Randomised Controlled Study of Comparison of Intraocular Pressure and Haemodynamic Responses to Insertion of the I-Gel, Classical Laryngeal Mask Airway and Endotracheal Tube

Khot¹,

Jamale²,

Dhulkhed³

et al. 2016

jemds

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BACKGROUNDThe I-gel is a supraglottic airway device with soft gel like non-inflatable cuff. Compared to Classical LMA, I-GEL does not require cuff inflation. I-gel works in harmony with the patient's anatomy, so that compression and displacement trauma are significantly reduced. LMA and I-gel are supraglottic airways compared to Endotracheal Tube (ETT), which is inserted inside the trachea. This study was done to determine the: 1. Intraocular pressure and 2. Haemodynamic response and compare it between I-gel insertion, classical LMA insertion and laryngoscopy with endotracheal intubation.

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Intraocular tension in association with succinylcholine and endotracheal intubation: a preliminary report

Cited by 40 publications

References 7 publications

Pediatric intraocular pressure measurements: Tonometers, central corneal thickness, and anesthesia

Pediatric intraocular pressure measurements: Tonometers, central corneal thickness, and anesthesia

A randomized comparative study of intraocular pressure and hemodynamic changes on insertion of proseal laryngeal mask airway and conventional tracheal intubation in pediatric patients

A Randomised Controlled Study of Comparison of Intraocular Pressure and Haemodynamic Responses to Insertion of the I-Gel, Classical Laryngeal Mask Airway and Endotracheal Tube

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