Oculocardiac Reflex and Postoperative Recovery in Pediatric Strabismus Surgery: A Randomized Trial Comparing Four Anesthetic Techniques.

Hong,  Jeong Yeon; Kil,  Hae Keum

doi:1999.37.6.1046

Clinical Research Article

Korean Journal of Anesthesiology 1999;37(6):1046-1053.
DOI: https://doi.org/10.4097/kjae.1999.37.6.1046

Oculocardiac Reflex and Postoperative Recovery in Pediatric Strabismus Surgery: A Randomized Trial Comparing Four Anesthetic Techniques.

Jeong Yeon Hong, Hae Keum Kil

¹Department of Anesthesiology, Sungkyunkwan University School of Medicine.
²Department of Anesthesiology, Yonsei University College of Medicine.

Abstract

BACKGROUND
Oculocardiac reflex (OCR) and postoperative nausea/vomiting are major complications of pediatric strabismus surgery. The aim of the study was to assess, in children undergoing strabismus surgery, the incidence of OCR and postoperative emesis with a inhalational and a intravenous technique.
METHODS
44 healthy children undergoing elective strabismus surgery as inpatients were randomly allocated to four anesthetic techniques: (1) induction with propofol, maintenance with propofol infusion and 50% N2O-O2 (propofol-N2O); (2) induction with propofol and fentanyl 1 microgram/kg bolus, maintenance with propofol infusion and 50% air-O2 (propofol-fentnyl-air); (3) induction with thiopental, maintenance with enflurane and 50% N2O-O2 (enflurane-N2O); (4) induction with thiopental and fentanyl 1 microgram/kg, maintenance with enflurane and 50% air-O2 (enflurane-fentanyl-air).
RESULTS
The incidence of an OCR significantly increased in the propofol-fentanyl-air group as compared to the enflurane-N2O or enflurane-fentanyl-air groups. Times to extubation were shorter in the propofol- N2O group than in the propofol-fentanyl-air or enflurane-fentanyl-air groups. Alertness scores were lower in the propofol-N2O group than in the enflurane-N2O or enflurane-fentanyl-air groups. Postanesthetic recovery scores and nausea/vomiting during the 24 hr after the operation did not show any differences among the groups.
CONCLUSIONS
We concluded that children undergoing strabismus surgery anesthetized with propofolfentanyl-air had more episodes of OCR, propofol-N2O had shorter times to extubation and higher alertness scores, and the addition of N2O or fentanyl to anesthetic regimen was not associated with nausea and vomiting.

Key Words: Anesthetics, intravenous, fentanyl, propofol; Anesthetics, volatile, enflurane; Complication, oculocardiac reflex, vomiting; Surgery, strabismus