Tahira Hakim Shah, Rukhsana Samad, Momin Salahuddin, Syed Hassan Shah, Ahmad Jawad Mufti, Shafiq Rahman, Hina Syed.
Oculocardiac refelx in strabismus surgery under general anesthesia.
J Med Sci Jan ;21(2):84-7.

Objective: To compare the incidence of oculocardiac reflex with pre-medication, atropine sulphate, and without premedication in strabismus (squint) surgery. Material and Methods: This study was a randomized control trial performed in the department of anesthesia at Khyber Teaching Hospital, Peshawar form January 2012 to September 2012. Eighty patients of ages between 10 to 18 years were randomly divided into two groups. The patients in Group A were pre-medicated with an anticholinergic drug (atropine sulphate) while the patients in group B were not administered any pre-medications. Patients in both the groups were anesthetized with similar drugs during strabismus surgeries. Patients were monitored using blood pressure, electrocardiography and heart rate monitor. Dysrhythmias occurring during anesthesia were identified and documented in each group. Results: Dysrhythmias were observed in both the groups but the incidence was very high among patients from group B. In group A 2 patients (5 percent) while in group B 25 patients (65 percent) developed dysrhythmias. In both the groups only 2 patients (3 percent) developed ventricular ectopics while 25 patients (31 percent) developed bradychardia. Conclusion: This study shows that the incidence of oculocardiac reflex is very high in patients who were not pre-medicated with an anticholinergic drug. Hence, all the patients requiring general anesthesia for eye surgeries should have a proper anticholinergic pre-medication.

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