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M. Motta, J. Coblentz, B. Fernandes; Mydriatic and Cardiovascular Effects of Phenylephrine 2.5% versus Phenylephrine 10% Both Associated With Tropicamide 1%. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5827.
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To evaluate and compare cardiovascular effects (blood pressure and heart rate) of Phenylephrine 2.5% versus Phenylephrine 10%. To compare pupil diameter before and after instilation of eyedrops.
This is a prospective, interventional, randomized, comparative study. A total of 58 patients scheduled for fundus examination were dilated with either Phenylephrine 2.5% and Tropicamide 1% (group 0) or Phenylephrine 10% and Tropicamide 1% (group 1). In both groups, blood pressure, heart rate and pupil diameter were measured before and 40 minutes after eyedrops instilation.
Both groups were similar regarding age and sex, as well as history of hypertension before examination (p=0.07, Kruskal-Wallis test). Mean blood pressure median was 93.3 mmHg in group 0 and 96.6 mmHg in group 1. After eyedrops, values were 93.3 mmHg in group 0 and 96.6 mmHg in group 1, with no significant variation concerning blood pressure (p=0.40). The heart rate median in group 0 was 75 bpm before instilation and 71 bpm after medication; in group 1, values were 77 bpm and 72 bpm respectively. Statistical analysis did not show significant difference between these values (p=0.80). Mean pupil diameter in group 0, before eyedrops, was 3.00 mm, and 2.65 mm in group 1. After medication, mean values were 7.38 mm in group 0 and 7.40 mm in group 1. Variation was 4.38 mm in group 0 and 4.75 mm in group 1, which was statistically significant (p=0.01).
The combination of Tropicamide 1% with Phenylephrine 10 % provides a better mydriatic effect than Tropicamide 1% with Phenylephrine 2.5%, without significant adverse cardiovascular effects.
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