Abstract:AIM:To assess the effect of applying retrobulbar anesthesia or atropine pretreatment as an available method to prevent oculocardiac reflex(OCR).
METHODS:A total of 92 pediatric patients(166 eyes)aged 5-13 years old who underwent elective strabismus surgery from March 2015 to March 2016 were enrolled and randomly assigned into three groups. Traditional anesthesia(TA)group was intravenously injected with propofol 2 mg/kg, fentanyl 1 mg/kg and atracurium 0.5mg/kg. Retrobulbar anesthesia(RA)group received both traditional anesthesia and retrobulbar injection of 2% lidocaine 2mL. Atropine pretreatment(AP)group received both traditional anesthesia and intravenous injection of atropine 0.15 mg/kg before surgery. The heart rate decreased by over 10% from the baseline value was considered as OCR positive. The anesthesia time, operation time, the baseline value of heart rate and the muscles induced OCR were recorded and analyzed.
RESULTS:The incidence of intraoperative OCR was 20% in RA group, 22% in AP group and 58% in TA group. There was no significant difference in anesthesia time, operation time, the baseline value of heart rate and corrective rate of postoperative eye position among three groups(P>0.05).
CONCLUSION: Retrobulbar anesthesia and atropine pretreatment both effectively reduced the incidence of OCR in children's strabismus surgery, which could be potentially effective methods to prevent OCR and further provide more operation security for children with strabismus.