Effect of Rocuronium and Succinylcholine on Intraocular Pressure during Rapid Sequence Induction and Endotrachial Intubation

Abstract

Abstract

Effect of Rocuronium and Succinylcholine on Intraocular Pressure during Rapid Sequence Induction and Endotrachial Intubation

Background and Objectives: Patients who require endotrachial intubation in the emergency department often require a rapid sequence induction(RSI) technique to protect against gastric contents aspiration and facilitate intubation. Two muscle relaxants which are commonly used during RSI are Succinylcholine and Rocuronium. Both of them can cause undesirable rise in Intraocular pressure (IOP).The present study was undertaken to compare the effects of these two drugs on IOP. Material and Methods : It was a prospective randomized study on 60  patients aged 20-50 years, and of ASA grade I and II, undergoing elective abdominal surgery in a tertiary care referral hospital. IOP was measured preoperatively and then just before intubation, immediately after intubation, one minute, three minutes and five minutes after intubation. Results: Succinylcholine had significantly higher mean IOP as compared to Rocuronium before intubation till three minutes after intubation (p <0.001). When change in IOP was compared from baseline, Succinylcholine showed an increase in mean IOP till one minute after intubation while Rocuronium had a decrease in mean IOP at all time intervals. Conclusion: Of the two muscle relaxants used for RSI, Rocuronium has better control over IOP and other side effects as compared to Succinylcholine.

Key Words: Rapid Sequence Induction, Intra Ocular pressure, Rocuronium, Succinylcholine.