Abstract
Purpose To investigate the cardiovascular response to the subconjunctival injection of 0.25 ml of Mydricaine No. 1 during vitrectomy surgery.
Methods Pulse and blood pressure were recorded at 5 min intervals before and following the subconjunctival injection of Mydricaine No. 1 in a group of 49 sequential patients undergoing vitrectomy surgery under general anaesthetic during a 6 month period. These responses were compared with a sequential and similar group of 35 patients during the following 6 months.
Results Ten patients in the group administered Mydricaine, but no patients in the control group, developed a sinus tachycardia of >100 beats/min for more than 10 min which was attributable to the mydriatic regime used. The occurrence of this response was not predictable based on the patients' age, weight or the presence of conjunctival erythema. The magnitude and temporal course of the tachycardia observed were variable. Blood pressure recordings showed no clinically significant changes during the tachycardias.
Conclusion Twenty per cent of patients administered 0.25 ml of Mydricaine No. 1 subconjunctivally develop a significant sinus tachycardia following injection. This response is unpredictable and all patients given Mydricaine should be monitored carefully after injection.
Similar content being viewed by others
Article PDF
References
Hartstein I, Deutsch N . Adverse effects of subconjunctival injections of mydriatic agents [letter]. Br J Ophthalmol 1991;75;253.
Jayamanne DGR, Fitt AWD, Wariyer R, Cottrell DG . Persistent tachycardia following subconjunctival injections of mydriatic agents (Mydricaine) used for maintenance of perioperative mydriasis in vitreoretinal surgery. Eye 1995;9:530–l.
Pandit JC . Tachycardia and myocardial ischaemia following subconjunctival injection of Mydricaine No. 2. Eye 1994;8:599.
Jayamanne DGR, Ray-Chaudhuri N, Wariyar R, Cottrell DG . Haemodynamic responses to subconjunctival mydriatic agents (Mydricaine) used for maintenance of perioperative mydriasis in patients undergoing vitreretinal surgery. Eye 1998;12:792–4.
Goodman LS, Gilman A . The pharmacological basis of therapeutics. 6th ed. New York: McGraw-Hill, 1975:518.
Barash PG, Cullen BF, Stoelting RK . Clinical anaesthesia. 1st ed. Philadelphia: JB Lippincott. 1989:193.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Steel, D., Thorn, J. The incidence of systemic side-effects following subconjunctival Mydricaine No. 1 injection. Eye 13, 720–722 (1999). https://doi.org/10.1038/eye.1999.214
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1038/eye.1999.214
Keywords
This article is cited by
-
Subconjunctival 0.1% epinephrine versus placebo in maintenance of mydriasis during vitrectomy: a randomized controlled trial
International Journal of Retina and Vitreous (2018)
-
Supraventricular ectopics and supraventricular tachycardia following injection of subconjunctival Mydricaine No. 2
Eye (2001)