Comparison of desflurane with sevoflurane for the incidence of oculocardiac reflex in children undergoing strabismus surgery

Oh, Ah Young; Yun, Mi Ja; Kim, H.J.; Kim, H.S.

doi:10.1093/bja/aem145

Cited by 32 publications

(36 citation statements)

References 18 publications

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“…[13][14][15][16][17] Other studies have defined this reflex to include a 10-30% decrease in HR from baseline. [18][19][20] It is a trigeminal-vagal reflex that can lead to a variety of arrhythmias, including sinus bradycardia, junctional rhythm, atrial ectopic, atrioventricular block, ventricular bigeminy, wandering pacemaker, multifocal premature ventricular contractions, idioventricular rhythm, ventricular tachycardia, or asystole.…”

Section: Definitionmentioning

confidence: 99%

“…20 Halothane is more likely to cause bradycardia, dysrhythmias, and ventilatory disturbances than sevoflurane, 13 whereas there is no difference between sevoflurane and desflurane and their effects on OCR. 17 …”

Section: Premedicationmentioning

confidence: 99%

“…2 A study comparing the effect on POV of fentanyl, meperidine, and peribulbar block, in combination with a propofol infusion, concluded that the highest incidence of POV was found in the meperidine group; the lowest was found in the peribulbar block, and Traction on extraocular muscles 23,24 Stimulation of orbital structures 5,17,18 Halothane [ sevoflurane 13 Remifentanil [ sevoflurane, Desflurane 15,16 Anesthetic management for pediatric strabismus surgery 607 fentanyl fell inbetween. 45 Other studies have shown that fentanyl increases PONV after strabismus surgery; 2 however, a propofol and sufentanil technique demonstrated less POV compared with a propofol and isoflurane technique.…”

Section: Opioidsmentioning

confidence: 99%

“…Un sondage réalisé au Royaume-Uni en 1999 a démontré que 60 % des anesthésiologistes utilisaient un LMA TM chez les enfants subissant une chirurgie du strabisme. 1 Traction sur les muscles extra-oculaires 23,24 Stimulation des structures orbitales 5,17,18 Halothane [ sévoflurane 13 Rémifentanil [ sévoflurane, desflurane 15,16 Anesthetic management for pediatric strabismus surgery 613 Ventilation La ventilation spontanée ou contrôlée peut être utilisée, mais il faut garder à l'esprit que l'hypercarbie peut augmenter l'incidence de ROC. 24 Une étude a examiné l'effet de la concentration d'oxygène inspiré sur l'incidence des NVPO.…”

Section: Prémédicationunclassified

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Anesthetic management for pediatric strabismus surgery: Continuing Professional Development

Rodgers

Cox

2010

Can J Anesth/J Can Anesth

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Purpose Strabismus surgery is one of the most common pediatric ophthalmic procedures. The purpose of this continuing professional development module is to update physicians on the anesthetic considerations of pediatric patients undergoing strabismus surgery. Principal findings The preoperative assessment is important, as patients undergoing strabismus surgery may have an associated neuromuscular disorder, congenital syndrome, or cardiac disease. Malignant hyperthermia is no longer considered as being an issue associated with strabismus. The laryngeal mask airway is used frequently and has been shown as being associated with a low incidence of complications in strabismus surgery. The anesthesia technique can be adapted to decrease the incidence of the oculocardiac reflex and the oculorespiratory reflex, and the use of anticholinergic prophylaxis remains debatable. Since patients are at high risk for postoperative nausea and vomiting (PONV), combination anti-emetic therapy is recommended using dexamethasone and ondansetron. Metoclopramide was not found to provide additional benefit when combined with other anti-emetics. Droperidol is effective, but there remains a black box warning for dysrhythmias. Effective analgesics in this patient population include acetaminophen, nonsteroidal anti-inflammatory drugs, peribulbar blocks, and subtenon blocks. Topical tetracaine drops have demonstrated mixed results, and topical nonsteroidal anti-inflammatory drops were found not to be effective. The use of opioids should be minimized due to the increased incidence of PONV. Conclusions To provide optimal care for the pediatric patient undergoing strabismus surgery, it is important to understand the unique anesthetic considerations for strabismus surgery and to appreciate how each decision regarding the anesthetic technique can alter these considerations. Objectives of this continuing professional development (CPD) moduleUpon completion of this CPD module, the reader will be able to:1 Perform a thorough preoperative assessment with an emphasis on the co-existing diseases and syndromes with ocular manifestations; 2. Evaluate the possibility of an increased incidence of masseter muscle spasm or malignant hyperthermia in this patient group; 3. Detail an anesthetic plan for strabismus surgery, including airway management and choice of anesthetic agents; 4. Understand the mechanism of the oculocardiac and the oculorespiratory reflex and recognize the associated risk factors and treatment; 5. Determine the analgesia options for strabismus surgery; and 6. Plan evidence-based anti-emetic prophylaxis for strabismus surgery. Summary reviewStrabismus surgery is the most common pediatric ophthalmic procedure. 1,2 The purpose of this continuing professional development module is to review the unique anesthetic issues facing a patient presenting for strabismus surgery. It is important to be aware of specific issues, such as the association with specific syndromes and diseases, the occurrence of the oculocardiac reflex, and the increas...

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Section: Definitionmentioning

confidence: 99%

Section: Premedicationmentioning

confidence: 99%

Section: Opioidsmentioning

confidence: 99%

Section: Prémédicationunclassified

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Anesthetic management for pediatric strabismus surgery: Continuing Professional Development

Rodgers

Cox

2010

Can J Anesth/J Can Anesth

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“…Sevofl urane is associated with a lower incidence of OCR than halothane or propofol [3]. The incidences of OCR during strabismus surgery with sevofl urane and desfl urane in children were similar [4]. Ketamine for anesthetic induction resulted in a lower incidence of OCR than propofol when combined with sevofl urane for maintenance in children undergoing strabismus surgery [5].…”

Section: Introductionmentioning

confidence: 97%

Effect of different anesthetic agents on oculocardiac reflex in pediatric strabismus surgery

et al. 2009

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Anesthesia for Ophthalmologic Surgery

Mani

Brodsky

2016

Out of Operating Room Anesthesia

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Comparison of desflurane with sevoflurane for the incidence of oculocardiac reflex in children undergoing strabismus surgery

Abstract: Both agents can be used safely during strabismus surgery in paediatric patients.

Cited by 32 publications

References 18 publications

Anesthetic management for pediatric strabismus surgery: Continuing Professional Development

Anesthetic management for pediatric strabismus surgery: Continuing Professional Development

Effect of different anesthetic agents on oculocardiac reflex in pediatric strabismus surgery

Anesthesia for Ophthalmologic Surgery

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