According to Miller, pharmacologic agents with the potential to increase intraocular pressure include succinylcholine, ketamine, and nitrous oxide. The increase after SCh peaks by 4 minutes and resolves by 6 minutes. Data regarding the attenuation of this increase following precurarization are mixed. Libonati et al. administered SCh to 73 patients with penetrating eye injuries and reported no loss of global contents.
Conversely, volatile anesthetics and intravenous opioids may decrease intraocular pressure.
Drugs Which May Increase IOP
- Succinylcholine (peak at 2-4 mins, resolves by 6 mins)
- Nitrous Oxide
Drugs Which May Decrease IOP
- Volatile Anesthetics
M M Libonati, J J Leahy, N Ellison The use of succinylcholine in open eye surgery. Anesthesiology: 1985, 62(5);637-40