Oculocardiac Reflex during Strabismus Surgery.

Kim, Hyun Kyung; Yoon, Kyung Chul; Park, Yeoung Geol

Original Article

Journal of the Korean Ophthalmological Society 2003;44(4):896-903.
Published online April 1, 2003.

Oculocardiac Reflex during Strabismus Surgery.

Hyun Kyung Kim, Kyung Chul Yoon, Yeoung Geol Park

Department of Ophthalmology, Chonnam University College of Medicine, Chonnam National University Research Institute for Medical Sciences, Kwangju, Korea. ygpark@chonnam.ac.kr

사시수술 중 발생하는 안구심반사에 대한 임상적 고찰

김현경 ( Hyun Kyung Kim ) , 윤경철 ( Kyung Chul Yoon ) , 박영걸 ( Yeoung Geol Park )

Abstract

PURPOSE
To investigate the factors that influence development of oculocardiac reflex (OCR) during strabismus surgery and to discuss the preventive strategies. METHODS: We examined patients undergoing surgery for strabismus. One hundred and sixty extraocular muscles of 73 patients were operated and 114 extraocular muscles of 50 patients who were operated under general anesthesia were evaluated. We investigated the incidence of the OCR and subsequent postoperative vaso-vagal response (VVR). RESULTS: An overall rate of 74.0% of the patients and 53.8% of the muscles showed a positive OCR. Under general anesthesia, 74.0% of the patients and 50.9% of the muscles showed a positive OCR. There was a significant difference in the frequency of OCR between the medial rectus and the other muscles (p=0.009). The development of OCR is frequent during muscle traction in strabismus surgery. There was a significant association between positive OCR and subsequent postoperative VVR (p=0.039). CONCLUSIONS: The predictive factors of the OCR during strabismus surgery under general anesthesia were muscle type and procedure. Therefore cardiac monitoring during the operation is needed and gentle manipulation of the extraocular muscles is important especially when the medial rectus muscle. The estimation of OCR will be helpful for prevention of subsequent postoperative VVR.

Key Words: Extraocular muscle;Oculocardiac reflex;Strabismus;Vasovagal reflex