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Intranasal Nitroglycerin and Intraocular Pressure during General Anesthesia

Received from the Department of Anesthesiology, Postgraduate Institute of Medical Education and Research, Chandigarh-160 012, India.

Abstract

Two separate studies of the effects of nitroglycerin (NTG) on intraocular pressure (IOP) were conducted. In study 1,12 healthy adults received 3 ml NTG solution (2 mg/3 ml) intranasally during steady-state anesthesia. This resulted in a significant decrease in IOP along with decreases in arterial blood pressure and central venous pressure. In study H, 30 patients, classified randomly into two equal groups, received either normal saline (3 ml) or NTG solution (2 mg/3 ml) intranasally, in a double-blind manner, 2 minutes before anesthetic induction with thiopental followed by succinylcholine (1.5 mg/kg). In patients given aline, IOP increased significantly above the preinduction levels after succinylcholine. Tracheal intubation increased it further. In the NTG group, increases in IOP after succinylcholine and after tracheal intubation were significantly less than in the control (saline) group. It is concluded that intranasal administration of NTG decreases IOP in anesthetized patients and, when employed as pretreatment, allows the use of succinylcholine to facilitate tracheal intubation without an increase in IOP above preinduction levels.

Key Words: EYE—intraocular pressure • PHARMACOLOGY—nitroglycerin • NEUROMUSCULAR RELAXANTS—succinylcholine

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999