Brazilian Journal of Anesthesiology
https://bjan-sba.org/journal/rba/article/doi/10.1016/j.bjane.2020.12.015
Brazilian Journal of Anesthesiology
Clinical Research

The association between surgical technique and oculocardiac reflex in pediatric strabismus surgery: an observational study

Yeliz Kılıç, Mehmet Sacit Gülec

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Abstract

Background and objectives
The most common cause of oculocardiac reflex (OCR) is traction of the extraocular muscles. Therefore, strabismus surgery is highly risk for the development of this complication. This study aimed to investigate whether an association exists between the occurrence of OCR and the type of extraocular muscle manipulated during strabismus in a pediatric population.

Methods
A total of 53 pediatric patients who were operated for strabismus under sevoflurane anesthesia were enrolled in this prospective study. The association between surgical techniques and the occurrence of OCR was investigated.

Results
This study included 30 (56.6%) males and 23 (43.4%) females, with a mean age of 8.4 years. Overall, 83 eyes with 93 extraocular muscles were operated. Surgery was performed most frequently on the medial (44.6%) and lateral (36.1%) recti. OCR occurred in 33 (62.3%) patients. OCR was found to be significantly higher in the first operated muscle compared with the second muscle, regardless of muscle type, as identified in the statistical analysis based on the sequence of the operated muscles.

Conclusions
The manipulation of the first extraocular muscle has a higher risk of OCR in the pediatric population undergoing two-muscle surgery for strabismus.

Keywords

Anesthesia;  Oculocardiac reflex;  Pediatrics;  Sevoflurane;  Strabismus
60268ffe0e8825dd723ee53c rba Articles
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Braz J Anesthesiol

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