AIM: To observe the changes of electrocardiogram(ECG), respiration, oxygen saturation and blood pressure in local anesthesia care cases in adult horizontal strabismus operation.

METHODS: Seventeen adult patients with clinical diagnosis of horizontal strabismus were enrolled to our study, including 19 eyes and 36 extraocular muscles. There were 10 males, 7 females, aged from 18- 71, with an average age of 32.65; 14 exotropia cases(8 males, 6 females), 3 esotropia cases(2 males, 1 female). All of the patients had the examination of best-corrected visual acuity(BCVA), slit-lamp microscope, indirect ophthal-moscopy, fluorescein and synoptophore. A professional anesthesiologist conducted the whole closely monitoring by using monitor during the operation. The changes of ECG, respiration, oxygen saturation and blood pressure between preoperative and intraoperative were comparatively analyzed with local anesthesia monitoring, the differences of medial and lateral rectus, different gender and different age group were compared.

RESULTS: There were 36 extraocular muscles pulled of the 17 cases adult horizontal strabismus in local anesthesia care, the incidence of oculocardiac reflex was 86.1%; pulling medial and lateral rectus, the positive rates of oculocardiac reflex were respectively 100% and 72.2%. Oculocardiac reflex had no statistical differences in different gender. The positive rates of oculocardiac reflex were significantly higher in 18-30 years than that of 31-71 years. Intraoperative respiratory frequency increased with oculocardiac reflex synchronization, but unrelated with pulling the rectus, gender and different age groups. No significant changes in oxygen saturation. Blood pressure appeared a transient increase at the beginning of the operation, a transient decrease when first pulling the rectus, there was no obvious difference in gender and age.

CONCLUSION: In local anesthesia care of adult horizontal strabismus operation, the oculocardiac reflex had a high incidence, pulling medial rectus occurred 100%; respiratory increased with oculocardiac reflex synchronization; blood pressure increased at the beginning, while decreased with pulling the rectus.