Comparison Of The Effect Of Lignocaine And Gallamine On Suxamethonium-induced Elevation Of Intraocular Pressure (lOP)

Abstract

This study was designed to determine the timecourse, incidence as well as magnitude of suxamethonium induced elevation of intraocular pressure (lOP); and to compare the effectiveness of pretreatment with either Lignocaine or Gallamine in attenuating this adverse effect of suxamethonium. The study sample consisted of inpatients presenting for elective either opthalmological or non-opthalmological surgery at the Kenyatta National Hospital (KNH). One hundred and fifty patients were randomly divided into three groups each consisting of 50 patients that were given pretreatment 3 minutes before induction of anaesthesia. The control group received 5mls of Normal saline and the remaining two test groups were pretreated with either Gallamine 0.5mg/kg or Lignocaine 1.5mg/kg. In all the 3 groups there was transient elevation of intraocular pressure which was only statistically significant in the control and Gallamine groups. The incidence of intraocular hypertension following intravenous suxamethonium and endotacheal intubation was found to be 80%. Mean increase in intraocular pressure from the resting to peak value was found to be 7.3mmHgin the Control group. Peak elevation in rap occured 3 minutes after intravenous administration of suxamethonium and returned to normal within 6 minutes in all the 3 groups. Only in the Lignocaine group was this elevation not statistically significant from the baseline values. rt was concluded for this study that Lignocaine pretreatment in a dose of 1. 5mg/kg given 3 minutes prior to induction of anaesthesia with Thiopentane is more effective in attenuating postsuxamethanium intraocular hypertension than Gallamine. Subsequently Lignoicane pretreatment was recommended whenever there is risk of prolapse of intraocular contents due to suxamethonium induced elevation of rap.