Comparison of the Effect of Atracurium and Cisatracurium on Intraocular Pressure and Pupillary Diameter

Purpose: Although there are ample evidences for the effects (mostly decrease) of intraocular pressure (IOP) after the administration of atracurium and cisatracurium during general anesthesia in ophthalmic operations, no study has yet been done to compare their effects on both IOP and pupillary diameter (PD) simultaneously. The aim of this study was to determine whether there is any difference between the effects of atracurium and cisatracurium on IOP and PD. Methods: Sixty patients with American Society of Anesthesiologists class I-II without history of previous eye surgery were studied in two randomly divided, double-blind groups. Following induction of anesthesia, atracurium (0.6 mg/kg) and cisatracurium (0.15 mg/kg) were administered to each group. IOP was measured by applanation tonometry (TONO – PEN ® XL) and PD (COLVARD pupillometer) at six sequential occasions, before induction of anesthesia, 2 and 5 minutes after induction and 2, 5 and 10 minutes after intubation prior to initiation of operation. Then they were compared to each other. Results: Trend of recorded IOP and PD values showed that there were no statistically significant differences between atracurium and cisatracurium according to their effect on IOP (p=0.125) and PD (p>0.137) during the course of study. Conclusion: It seems that both atracurium and cisatracurium have similar effects on IOP and PD before and up to ten minutes after tracheal intubation prior to surgical intervention.