References1 Gold RS, Pollard Z, Buchwald IP. Asystole due to the oculocardiac reflex during strabismus surgery: a report of two cases. Ann Ophthalmol 1988; 20: 477. 2 Mallinson FB, Coombes SK. A hazard of anaesthesia in ophthalmic surgery. Lancet 1960; 12: 574-575. 3 Fayon M, Gauthier M, Blanc VF et al. Intraoperative cardiac arrest due to the oculocardiac reflex and subsequent death in a child with occult Epstein-Barr virus myocarditis. Anesthesiology 1995; 83: 622-624. 4 Bolli R. Mechanism of myocardial ''stunning''. Circulation 1990; 82: 723-738 5 Fontes ML, Hines RL. Pharmacological management of perioperative left and right ventricular dysfunction. In: Kaplan AJ, ed.
The surgical repair of congenital dislocation of the hip was performed under normotensive anaesthesia (23 children) and hypotensive anaesthesia (52 children). Hypotension was induced with infusion of hypotensive agents such as trimetaphan or nitroglycerin during inhalation or neurolept-anaesthesia under careful monitoring of blood pressure, haematocrit and electrocardiogram. Blood replacement was done to keep hematocrit value above 30%. Blood loss was significantly less in hypotensive group (2.53 ml/kg/h) than that in normotensive group (4.53 ml/kg/h). Twenty one percent of patients in hypotensive group required blood transfusion with the rate of 3.3 ml/kg/h compared with 43% of cases in normotensive group with the rate of 4.4 ml/kg/h. Depending upon anaesthesia technique blood loss was greater in neuroleptanaesthesia (5.5 ml/kg/h) than inhalation (2.3 ml/kg/h) or epidural (2.1 ml/kg/h) anaesthesia. Urine output and laboratory data for liver and kidney functions were not different between normotensive and hypotensive group. The dose of hypotensive agents required to produce moderate hypotension for paediatric patients was much higher than that for adult. We consider that moderate hypotension is safe procedure if employed by well experienced anaesthetist with careful monitoring of blood pressure, Hct and ECG. Blood loss and requirement of blood replacement are significantly reduced with this technique.
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