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[High-dose vecuronium in "open-eye" emergency surgery]
A Di Filippo1, S Grechi, L Rizzo
1Istituto di Anestesiologia e Rianimazione, Università degli Studi, Firenze.
Minerva Anestesiologica
|November 1, 1995
Summary
High-dose vecuronium (0.2 and 0.3 mg/kg) did not alter intraocular pressure (IOP) or blood pressure in open-eye surgery patients. This neuromuscular blocker is effective for tracheal intubation when succinylcholine is contraindicated.
Area of Science:
- Anesthesiology
- Ophthalmology
- Pharmacology
Background:
- Succinylcholine is contraindicated in open-eye surgery due to increased intraocular pressure (IOP).
- High-dose vecuronium is known to reduce the onset time for orotracheal intubation.
Purpose of the Study:
- To evaluate the clinical efficacy of high-dose vecuronium (0.2 and 0.3 mg/kg) for open-eye emergency surgery.
- To assess the effects of high-dose vecuronium on intraocular pressure (IOP) in this patient population.
Main Methods:
- A randomized, prospective clinical trial was conducted with 40 patients undergoing vitrectomy.
- Patients received either 0.2 mg/kg or 0.3 mg/kg of vecuronium during anesthesia induction.
- Intraocular pressure (IOP) and systolic-diastolic pressure were measured at three time points: pre-induction, post-thiopentone, and post-vecuronium.
Main Results:
- Administration of vecuronium at both doses (0.2 and 0.3 mg/kg) did not significantly alter intraocular pressure (IOP).
- No significant changes in systolic-diastolic pressure were observed.
- All patients achieved maximal vocal cord relaxation and successful orotracheal intubation within 90 seconds.
Conclusions:
- High-dose vecuronium is a safe and effective alternative to succinylcholine in open-eye emergency surgeries.
- Vecuronium does not increase intraocular pressure, making it suitable for procedures where IOP elevation is a concern.