“Self-taming” of Succinylcholine-induced Fasciculations and Intraocular Pressure

Verma, R. S.

doi:10.1097/00000542-197903000-00019

Cited by 32 publications

(6 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Various methods to attenuate the effects of succinylcholine and intubation on IOP include selftaming 11 , pretreatment with nondepolarizing neuromuscular blocking agents, [12][13][14] lidocaine, 15 narcotics, nifedipine. 16 However, no modality is devoid of drawbacks and limitations.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of dexmedetomidine premedication on attenuation of intraocular pressure changes after succinylcholine and endotracheal intubation

2020

IJCA

View full text Add to dashboard Cite

Introduction: Succinylcholine, is one of the most commonly used muscle relaxant for rapid sequence airway management. It increases the Intraocular pressure (IOP) which is deleterious in open globe injuries. We studied the effects of Inj. dexmedetomidine, a highly selective α2-adrenoceptor agonist, on IOP and hemodynamic responses to succinylcholine and tracheal intubation. Materials and Methods: Sixty ASA I-II patients, scheduled for elective non-ophthalmic surgeries requiring general anesthesia were randomly premedicated by intravenous Inj. dexmedetomidine 0.4 µg/kg (Group-D) or saline (Group-S) (30 patients each group). Heart rate (HR), mean arterial pressure (MAP), and IOP (using Schiotz tonometer) were measured 10 minutes before and after the premedication, 30 seconds after succinylcholine and at 1, 5 and 10 minutes after intubation. Results: Ten minutes after Inj. dexmedetomidine administration, there was marked decrease in IOP. After intubation there was a rise in IOP, however it remained below baseline IOP (p=0.315) and remained low at 10 th minute after intubation (p<0.001) which was statistically significant. In the control group, there was a significant rise in IOP following Inj. succinylcholine and intubation which remained above baseline IOP even at 10 th minute after intubation. HR, Systolic and diastolic blood pressure, and MAP markedly increased at 1 minute following intubation in the control group whereas in dexmedetomidine group, they remained below baseline (p<0.001). Conclusions: Intravenous dexmedetomidine at a dose of 0.4 μg/kg can be used for attenuation of rise in IOP associated with succinylcholine and tracheal intubation in patients with open globe injuries.

show abstract

Section: Discussionmentioning

confidence: 99%

Efficacy of dexmedetomidine premedication on attenuation of intraocular pressure changes after succinylcholine and endotracheal intubation

2020

IJCA

View full text Add to dashboard Cite

show abstract

“…Both Laryngoscopy and intubation are noxious stimuli and are associated with stress response leading to hypertension, tachycardia and rise in IOP. 3 The rise in IOP is transient and may not be significant in otherwise normal individuals. But in patients with open globe injuries, it may result in expulsion of ocular contents, resulting in possible blindness.…”

Section: Discussionmentioning

confidence: 99%

“…6 In 1979 Verma et al utilizing indentation tonometry, claimed that a 10mg "selftaming" dose of succinylcholine prevented a subsequent rise in intraocular pressure. 3 Subsequently in 1980 Myers in a controlled study using applanation tonometry refuted Verma's claim. 7 In 1979 smith et al claimed intravenous lidocaine 1-2mg/kg pre-treatment may attenuate the haemodynamic response to laryngoscopy but such pre-treatment is ineffective in preventing the rise in intraocular pressure following succinylcholine and intubation.…”

Section: Discussionmentioning

confidence: 99%

A comparative evaluation of intravenous dexmedetomidine and oral clonidine in attenuating the rise in intra ocular pressure

Yadhuraj

Somasekharam

Vinay

et al. 2017

Int J Basic Clin Pharmacol

View full text Add to dashboard Cite

Background: Administration of Suxamethonium, laryngoscopy and intubation is associated with rise in intraocular pressure (IOP). The need to attenuate rise in IOP is of utmost importance, especially in patients with perforating injury of the eyeball. The present study was undertaken to compare the effectiveness of intravenous Dexmedetomidine 0.4μg/kg and oral Clonidine 3μg/kg in attenuating the rise in IOP following administration of suxamethonium, laryngoscopy and intubation.Methods: 150 patients of ASA I or II, aged between 18-60 years, who were posted for elective non-ophthalmic surgery requiring general anaesthesia were included in this study. Patients were randomly divided into 3 groups with 50 patients in each group. Group-D: Received 0.4μg/kg IV dexmed in 10ml sterile water, over 10 min before induction. Group-C: Received 3μg/kg oral clonidine two hours prior to surgery. Group-S: Control group.Results: IOP, MAP, and HR were recorded at baseline, before induction, after induction, 1 min, 3 min and 5 min after administration of suxamethonium. Although Suxamethonium laryngoscopy and intubation increased IOP in all the 3 groups there was significant reduced rise in IOP noted in dexmed group and clonidine group compared to study group (p= <0.001). Furthermore, patients in dexmed group had lesser rise in IOP compared to clonidine group (p= <0.001).Conclusions: We concluded that both intravenous dexmedetomidine 0.4μg/kg and oral clonidine 3μg/kg, significantly attenuated the rise in IOP associated with administration of suxamethonium, laryngoscopy and intubation. However intravenous dexmedetomidine proved better than oral clonidine in attenuating the rise in IOP.

show abstract

“…Thus different methods of pretreatment have been proposed to reduce or avoid suxamethonium-induced elevations of IOR Small doses of competitive muscle relaxants or "self-taming" doses of suxamethonium have been given [3]. Pretreatment with barbiturates and benzodiazepines has not proved successful [4].…”

Section: Discussionmentioning

confidence: 99%

Effects of thiopentone/suxamethonium on intraocular pressure after pretreatment with alfentanil

Polarz

Böhrer

Fleischer

et al. 1992

Eur J Clin Pharmacol

View full text Add to dashboard Cite

The effects of pretreatment with alfentanil on intraocular pressure (IOP) were investigated in 40 patients undergoing ophthalmic surgery. Patients were randomly allocated to two study groups. Group 1 patients (n = 20) received alfentanil 15 micrograms.kg-1, vecuronium 0.01 mg.kg-1, thiopentone 3-4 mg.kg-1, and suxamethonium 1 mg.kg-1 for anaesthetic induction, whereas patients in group 2 (n = 20) received vecuronium 0.01 mg.kg-1, thiopentone 3-4 mg.kg-1, and suxamethonium 1 mg.kg-1. A total of seven measurements of intraocular pressure were taken in each patient, starting before premedication and ending after extubation of the trachea. In group 2 patients, there was an increase in IOP after endotracheal intubation. In group 1 patients, a decrease in IOP occurred which was related to the decrease in arterial blood pressure. We conclude that alfentanil pretreatment can prevent the increase in IOP following suxamethonium administration.

show abstract

“Self-taming” of Succinylcholine-induced Fasciculations and Intraocular Pressure

Cited by 32 publications

References 0 publications

Efficacy of dexmedetomidine premedication on attenuation of intraocular pressure changes after succinylcholine and endotracheal intubation

Efficacy of dexmedetomidine premedication on attenuation of intraocular pressure changes after succinylcholine and endotracheal intubation

A comparative evaluation of intravenous dexmedetomidine and oral clonidine in attenuating the rise in intra ocular pressure

Effects of thiopentone/suxamethonium on intraocular pressure after pretreatment with alfentanil

Contact Info

Product

Resources

About