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Effect of different doses of cisatracurium on intraocular pressure in sedated patients

Published online by Cambridge University Press:  16 August 2006

S. M. Sator-Katzenschlager ,
M. J. Oehmke ,
M. Kontaratos ,
A. Wedrich ,
G. Heinze  and
C. Weinstabl
S. M. Sator-Katzenschlager
Affiliation:
University of Vienna, Department of Anaesthesiology and General Intensive Care (B), Vienna, Austria University of Vienna, Department of Anaesthesiology and General Intensive Care (A), Vienna, Austria
M. J. Oehmke
Affiliation:
University of Vienna, Department of Anaesthesiology and General Intensive Care (B), Vienna, Austria
M. Kontaratos
Affiliation:
University of Vienna, Department of Anaesthesiology and General Intensive Care (A), Vienna, Austria
A. Wedrich
Affiliation:
University of Vienna, Department of Ophthalmology and Optometrics, Vienna, Austria
G. Heinze
Affiliation:
University of Vienna, Departments of Medical Computer Sciences, Vienna, Austria
C. Weinstabl
Affiliation:
University of Vienna, Department of Anaesthesiology and General Intensive Care (A), Vienna, Austria
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Abstract

Background and objective: The aim was to examine the course of intraocular pressure after relaxation with different doses of cisatracurium.

Methods: The investigation was carried out as a prospective, randomized double-blind study in a crossover design in 30 postoperative patients with stable haemodynamic and respiratory function (ASA I and II). To exclude any disrupting factors, patients remained intubated and continuously sedated. Twenty patients received an intubation dose (2 × ED95) of cisatracurium (0.1 mg kg−1) compared with atracurium (0.5 mg kg−1). In a second series, 10 patients were given an effective dose, ED95 (0.05 mg kg−1), and a repeat dose (0.02 mg kg−1) of cisatracurium. The intraocular pressure was determined before (T0) as well as 1 (T1), 5 (T5), 10 (T10), 15 (T15), 20 (T20) and 45 (T45) min after bolus administration.

Results: Intraocular pressure decreased after an intubation dose of either cisatracurium or atracurium, and reached a minimum after 10 min (6.7 ± 2.2 and 7.9 ± 2.1 mmHg, respectively). There was no significant difference between either muscle relaxant (P = 0.27). When lower doses of cisatracurium (0.05 and 0.02 mg kg−1) were applied, the intraocular pressure also decreased, albeit to a lesser extent and with a delayed onset (8.4 ± 1.9 mmHg after 10 min, 9.9 ± 3.4 mmHg after 15 min). There was no significant difference between dosages (P = 0.44).

Conclusions: Cisatracurium is a useful drug in patients when a decrease of intraocular pressure is wanted and where muscle relaxation is necessary and acceptable.

Keywords

neuromuscular non-depolarizing agentsatracuriumcisatracuriumocularphysiologyintraocular pressure
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 19 , Issue 11 , November 2002 , pp. 823 - 828
Copyright
2002 European Society of Anaesthesiology

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