Propofol Does not Prevent to Increase Intraocular Pressure During Tracheal Intubation / 대한마취과학회지

ABSTRACT

BACKGROUND: Anesthesiologists should understand the physiology of intraocular pressure and the implications of anesthetic drugs and maneuvers on intraocular pressure(IOP). Although most anesthetics reduce IOP, succinylcholine causes a transient but significant increase in IOP. And thiopental by itself does not prevent to increase blood pressure, IOP. This study was designed to evaluate the preventive effect of propofol on IOP changes during tracheal intubation. METHODS: IOP was measured with a hand-held applanation tonometer in the eye. Baseline(control) IOP was measured before the induction of anesthesia(stage 1) and serial measurements of IOP were made after administration of the induction agent before intubation(stage 2), immediately after intubation(stage 3) and 10 minutes after intubation(stage 4). Heart rate and systolic blood pressure were recorded simultaneously. According to induction agent and neuromuscular blocker, the 60 patients were divided into control group(C; thiopental, succinylcholine), pretreatment group(T) using defasciculation dose of vecuronium bromide, propofol group(P; propofol, succinylcholine) and vecuronium group(V; propofol, vecuronium bromide). RESULTS: Administration of either propofol or thiopenal resulted in a significant reduction in IOP(P<0.01). At stage 2, IOP of gpoup P and V were significantly lower than that of group C(P<0.05). At stage 3, IOP increased significantly compared to the values of stage 1 in all group(P<0.01). At stage 4, IOP decreased significantly compared to the values of stage 1 in all group(P<0.01), but there was no significant difference between groups in IOP at stage 4. CONCLUSIONS: Propofol may be a useful induction agent of general anesthesia for opthalmic surgery, but cannot prevent to increase IOP during endotracheal intubation.