Dexmedetomidine versus sufentanil premedication for blunting the increase in intraocular pressure and hemodynamic response during rapid-sequence induction

Abstract EN

Background / aim : this randomized, double-blind, prospective study was undertaken to compare the ef-fect of dexmedetomidine versus sufentanil premedication on the intraocular pressure (IOP) and hemody-namic response to larnygoscopy and tracheal intubation using succinylecholine as a neuromuscular block for rapid sequence induction. Patients and methods : 90 patients (ASA physical status I) who underwent elective non ophthalmic surger-ies were randomly divided into three double-blind groups, 30 patients each, according to the premedica-tion given just before induction of anesthesia: Group I (sufentanil group n = 30) : received sufentanil 0.05ug.

kg-1 I v infusion over 10 minutes.

Group II (dexmedetomidine group n = 30) : received dexmedetomidine 0.6 ug.

kg-1 I v infusion over 10 minutes.

Group III (placebo group n = 30) : received nor-mal saline 0.9 % Iv infusion over 10 minutes.

Anesthesia management of all patients was standardized.

Intraocular pressures , HR, MAP were measured at the following period A0 (before the start of premedi-cation ), A1( immediate after completion of premedication), A2(immediate before succinylcholine injec-tion), A3( immediate after succinylcholine fasciculation),A4(immediate after tracheal intubation), A5( 5 minutes after tracheal intubation ), and A6 (10 minutes after tracheal intubation). Results : intraocular pressure (IOP) , heart rate(HR ), mean arterial pressure(MAP) at the following times A1, A2, A3, A4, A5 were significantly lower in group I (sufentanil group) and group II (dexmedetomidine group )than group III(placebo group ),there was no significant difference between group I and II. Conclusion : dexmedetomidine premedication is as effective as sufentanil for blunting the increase of the IOP and hemodynamic response to laryngoscopy and intubation using succinylcholine as a neuromuscu-lar block for rapid sequence induction.