نقش نيفديپين زيرزباني در جلوگيري از افزايش فشار داخل چشمي ناشي از لوله گذاري تراشه

The Role of Sublingual Nifedipine on Prevention of Intraocular Pressure Rise Caused by Tracheal Intubation

Background: The succinylcholine administration and tracheal intubation causes significant rise of intraocular pressure (I.O.P), which is of special concern in penetrating ophthalmic injuries. Different methods have been suggested to prevent this complication, but none of them were completely successful. Reports of use of calcium channel blocking agents specially nifedipine for prevention of I.O.P rise after succinylcholine administration for tracheal intubation have been published. The present study was performed to evaluate the effect of sublingually administered nifedipine on I.O.P rise after succinylcholine administration and tracheal intubation. Materials and Methods: Fifty patients of both genders 30 - 40 years, having ASA physical status 1 without any ophthalmic, hypertensive or cardiac disease scheduled for non ophthalmic surgery in Shiraz Khalili hospital , were selected and divided into two case and control groups randomly. Twenty minutes before the induction of anesthesia, the patients in the case group were given a 10 mg capsule of nifedipine and the ones in the control group, a placebo capsule sublingually. The induction and maintenance of anesthesia was the same in the two groups. I.O.P and systolic blood pressure (S.B.P) were recorded before and 20 minutes after nifedipine or placebo administration. Just after the induction of anesthesia the I.O.P and S.B.P were again recorded as well as at the intervals of one, three and five minutes following intubations. The recorded data were compared in both case and control groups and analyzed statistically. Results: In case group after the administration of nifedipine, during all stages of anesthetic induction and following tracheal intubation I.O.P remained below baseline, but in the control group, the I.O.P raised significantly (p<0.05). On the other hand comparison of systolic blood pressure recording in both case and control groups showed no difference. Conclusion: According to the data obtained in this study, it is concluded that sublingual nifedipine successfully prevents I.O.P rise following induction of anesthesia and tracheal intubation. Since the prevention of the rise of I.O.P especially in penetrating injuries of the eye is of utmost importance, the use of sublingual nifedipine before the induction of anesthesia is strongly suggested.