Atracurium, vecuronium, and intraocular pressure in humans

We studied 60 nonophthalmologic patients, allocated to six treatment groups, to assess the effects of atracurium and vecuronium on intraocular pressure (IOP). All patients had IOP measured while awake, using pneumotonometry. In group 1, anesthesia was induced with thiopental, 5 mg/kg, and maintained with N2O, 70% in O2, using controlled mask ventilation, for 5 min. These patients then received atracurium, 0.5 mg/kg. After 5 additional minutes of ventilation, the trachea was intubated. From 1 min after thiopental administration until 1 min after intubation, IOP was recorded every minute. Patients in groups 2, 3, and 4 were treated identically to those in group 1, except the muscle relaxant given was atracurium, 1.0 mg/kg, vecuronium, 0.1 mg/kg, or vecuronium, 0.2 mg/kg, respectively. Patients in groups 5 and 6 underwent rapid sequence induction with thiopental, 5 mg/kg, and atracurium, 1.0 mg/kg, or vecuronium, 0.2 mg/kg, respectively. IOP was measured 1 min later, followed by intubation and IOP measurements for the next 3 min. Intraocular pressure decreased significantly in groups 1, 2, 4, and 6 after thiopental and remained stable in all groups during ventilation with N2O. Neither atracurium nor vecuronium affected IOP, nor was there any correlation between IOP and degree of neuromuscular blockade. However, IOP increased significantly after intubation in all six groups. We conclude that atracurium or vecuronium alone has no adverse effects on IOP.