Oculocardiac Reflex and Postoperative Recovery in Pediatric Strabismus Surgery: A Randomized Trial Comparing Four Anesthetic Techniques.
10.4097/kjae.1999.37.6.1046
- Author:
Jeong Yeon HONG
1
;
Hae Keum KIL
Author Information
1. Department of Anesthesiology, Sungkyunkwan University School of Medicine.
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
Anesthetics, intravenous, fentanyl, propofol;
Anesthetics, volatile, enflurane;
Complication, oculocardiac reflex, vomiting;
Surgery, strabismus
- MeSH:
Child;
Enflurane;
Fentanyl;
Humans;
Incidence;
Inpatients;
Nausea;
Postoperative Nausea and Vomiting;
Propofol;
Reflex, Oculocardiac*;
Strabismus*;
Thiopental;
Vomiting
- From:Korean Journal of Anesthesiology
1999;37(6):1046-1053
- CountryRepublic of Korea
- Language:Korean
-
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.
