Effect of rocuronium compared with succinylcholine on intraocular pressureduring rapid sequence induction of anaesthesia

We have compared the effect of rocuronium and succinylcholine on intraocula r pressure (IOP) during rapid sequence induction of anaesthesia using propo fol and fentanyl, in a randomized, double-blind study. We studied 30 adult patients, allocated to one of two groups. Anaesthesia was induced with fent anyl 2 mu g kg(-1) and propofol until loss of verbal response. This was fol lowed by succinylcholine 1.5 mg kg(-1) (group S; n=15) or rocuronium 0.9 mg kg(-1) (group R; n=15). Laryngoscopy was performed 60 s later. IOP, mean a rterial pressure (MAP) and heart rate (HR) were measured before induction, immediately before intubation and every minute after intubation for 5 min. A Keeler Pulsair air impulse tonometer was used to measure IOP and the mean of two readings obtained in the right eye at each measurement time was rec orded. Intubating conditions were evaluated according to a simple scoring s ystem. IOP in the succinylcholine group was significantly greater than that in the rocuronium group (mean 21.6 (SEM 1.4) mm Hg vs 13.3 (1.4) mm Hg; P< 0.001). Intubating conditions were equally good in both groups. We conclude that with rapid sequence induction of anaesthesia using propofol and fenta nyl, rocuronium did not cause as great an increase in IOP as succinylcholin e and may be an alternative in open eye injury cases.