The Oculocardiac Reflex

Bharati, Sachidanand Jee; Chowdhury, Tumul

doi:10.1016/b978-0-12-800421-0.00007-2

Cited by 5 publications

(1 citation statement)

References 43 publications

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“…Given the incidence and consequences of OCR, its treatment and prevention has become the most important aspect in terms of patient safety during operations that can cause this phenomenon. The management strategy for OCR includes the following measures: risk ' '1' ' refers to measurement of the parameters before the induction of anaesthesia ' '2' ' refers to the measurement of the parameters for surgical eyeball traction stratification, prophylaxis, surgical technique modification, appropriate anaesthetic management and cardiovascular monitoring [20].…”

Section: Discussionmentioning

confidence: 99%

Prediction of the Occurrence of the Oculocardiac Reflex Based on the Assessment of Heart Rate Variability. An Observational Study

et al. 2022

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Introduction: Ophthalmic surgery is assumed to be safe, but some operations require general anaesthesia which is associated with a number of potential complications. In addition, adverse cardiovascular symptoms, such as severe slowing of the heart rate and, in some cases, cardiac arrest may occur due to the surgical technique. The aim of this study was to determine whether it is possible to predict the occurrence of oculocardiac reflex (OCR) based on heart rate variability (HRV) analysis for autonomic nervous system (ANS) activity assessment measured prior to the induction of anaesthesia and immediately before eyeball traction. Methods: Fifty-two adults of both sexes (age range 18-65 years) with American Society of Anesthesiologists (ASA) physical status class 1 and 2 were enrolled in this study. All patients had underwent episcleral buckling under general anaesthesia. High-frequency (HF) changes in HRV are thought to reflect parasympathetic impulse transmission, whereas low-frequency (LF) changes reflect both sympathetic and parasympathetic activity. However, in practice, LF changes can be considered to reflect sympathetic changes. Thus, the LF/HF ratio reflects the actual balance between sympathetic and parasympathetic activity. Based on that, frequency domain HRV parameters from 5-min Holter electrocardiogram recordings before anaesthesia induction and before eyeball traction were used for the analysis. The statistical analysis also included patient age, sex, ASA status and preanaesthesia and premanoeuvre heart rate and blood pressure. Results: Data from 42 patients were analysed. Oculocardiac reflex was observed in 32 patients (76.2%). No difference was found in the analysed parameters between patients with and without oculocardiac reflex. There was no relationship between the incidence of the OCR and the analysed parameters. Conclusion:The prediction of OCR based on initial ANS tone was not possible, and the initial heart rate, blood pressure, age, sex, and ASA status were not helpful for the identification of patients at risk of this reflex.

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Section: Discussionmentioning

confidence: 99%