The Effects of Lidocaine, Fentanyl, and Remifentanil on Hemodynamics and Intraocular Eye Pressure After Tracheal Intubation: A Randomized Clinical Trial

INTRODUCTION: An increased reflex in sympathetic and sympathoadrenal activity caused by tracheal intubation causes an increase in arterial blood pressure, and increased venous pressure causes an increase in intraocular pressure (IOP). The aim of the current study was to compare the effects of lidocaine, fentanyl, and remifentanil to determine which agent was most effective in the prevention of elevated IOP.
METHODS: The patients were separated into 3 groups (lidocaine, fentanyl, and remifentanil). Heart rate and mean arterial pressure (MAP) were measured and recorded 2 min after the administration of the drugs and at 1, 5, and 10 min after intubation. IOP was measured and recorded in each eye separately by an ophthalmologist preoperatively, at 2 min after drug administration and at 1, 5, and 10 min after intubation.
RESULTS: MAP was found to be high (122.750±17.068) in the lidocaine group at 1 min after intubation. In all 3 groups, the right and left eye IOP values were found to be higher at 1 min after intubation than at 2 min after drug administration. Only the difference in the lidocaine group was statistically significant (p=0.003). In all 3 groups, the right and left eye IOP values at 5 min after intubation were statistically significantly lower than the values at 1 min after intubation (Group 1: p=0.001, Group 2: p=0.000, and Group 3: p=0.000).
DISCUSSION AND CONCLUSION: From the results of this study, it was concluded that remifentanil and fentanyl were more effective drugs than lidocaine in the prevention of increased IOP and hemodynamic response to intubation, and there was no significant difference between these two drugs.