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Effects of intubation with a double-lumen endotracheal tube on intraocular pressure during rapid sequence induction using succinylcholine chloride in patients with or without underlying systemic hypertension
Anesth Pain Med 2019;14(4):449-55
Published online October 31, 2019
© 2019 Korean Society of Neuroscience in Anesthesiology and Critical Care.

Chan-oh Park1, Hojun Ro2 , and Jaemin Lee2
Department of Anesthesiology and Pain Medicine, 1Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, 2Uijeongbu St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Uijeongbu, Korea
Correspondence to: Jaemin Lee, M.D., Ph.D. Department of Anesthesiology and Pain Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, College of Medicine, 271 Cheonbo-ro, Uijeongbu 11765, Korea Tel: 82-31-820-3256 Fax: 82-31-847-3449 E-mail:
Received May 2, 2019; Revised July 31, 2019; Accepted August 1, 2019.
cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: Tracheal intubation is closely associated with increases in intraocular pressure (IOP); however, the effects of double-lumen tube (DLT) intubation on IOP have not been validated. Systemic hypertension (HTN) is another factor that may increase IOP. In this study, we observed differences in IOP increases between DLT and singlelumen tube (SLT) intubation, and evaluated the influence of underlying HTN during rapid sequence induction.
Methods: Sixty-eight patients were allocated into one of the following group: SLT/without HTN (n = 17), SLT/HTN (n = 17), DLT/without HTN (n = 17), and DLT/HTN (n = 17). An SLT was inserted for orthopedic or gynecological surgery, and a DLT was inserted for lung surgery after rapid sequence induction using succinylcholine. IOP was measured before anesthetic induction and until 10 min after intubation using a handheld tonometer (Tono-Pen AVIA®).
Results: In the DLT/without HTN and DLT/HTN groups, the maximum increases in IOPs after tracheal intubation were 7.9 and 12.2 mmHg, respectively, compared to baseline. In the SLT/without HTN and SLT/HTN groups, the maximum increases were 5.0 and 4.9 mmHg, respectively, compared to baseline. In comparisons between patients with and without underlying HTN, the values of IOPs were comparable.
Conclusions: Tracheal intubation with a DLT is associated with more increases in IOPs than with an SLT in rapid sequence induction. Well-controlled underlying hypertension did not increase IOP during tracheal intubation.
Key Words : Double-lumen tracheal tube; Hypertension; Intraocular pressure; Intubation, intratracheal.

October 2019, 14 (4)
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