Canadian Anaesthetists’ Society Journal

, Volume 30, Issue 4, pp 360–369 | Cite as

The oculocardiac reflex: a graphic and statistical analysis in infants and children

  • Victor Faria Blanc
  • Jean-François Hardy
  • Jean Milot
  • Jean-Louis Jacob
Article

Abstract

A new method for the detection and recording of the oculocardiac reflex (OCR) is described and applied to 49 healthy infants and children (six months to nine years old) undergoing strabismus surgery under halothane anaesthesia with spontaneous ventilation. Eighty-one extraocular muscles were studied. Square wave stimuli (abrupt and sustained tractions) were definitely more reflexogenic than slow slope stimuli (very gradual, progressive and gentle tractions). Vagai escape, as well as fatigue of the OCR, are graphically documented and analysed. In this series, using well-defined and controlled tractions, the medial reclus was not more reflexogenic than the other extraocular muscles. Hypercapnia was an important adjuvant factor of the OCR. Controlled ventilation is recommended. The routine use of intravenous amicholinergic drugs is briefly discussed. Prevention of the OCR, and prophylaxis of cardiac arrhythmias during strabismus surgery, now seem to be placed on a more rational basis.

Key word

oculocardiac reflex surgery strabismus anaesthesia paediatric vagal escape arrhythmias cardiac anticholinergic antimuscarinic drugs hvpercapnia 

Résumé

Les auteurs décrivent une nouvelle méthode d’enregistrement graphique pour l’étude du réflexe oculocardiaque (ROC) et l’emploient chez 49 enfants (six mois à neuf ans; état physique l de la classification ASA) soumis à des corrections de strabisme et anesthésiés à l’halothane en respiration spontanée. Les stimulations brusques et soutenues étaient définitivement plus réfiexogènes que les stimulations progressives et délicates (P = 0.03). L’échappement vagai et la fatigue du ROC sont graphiquement documentés et analysés. L’emploi de stimulations d forme et à intensité bien définies révéla que le droit interne n’était pas plus réfiexogène que les autres muscles extrinsèques de l’il. L’hypercapnie était un facteur adjuvant important dans le déclenchement du ROC. La respiration contrôlée est recommandée, au moins lors des tractions musculaires. L’usage routinier d’agents anticholinergiques par voie intraveineuse est brièvement discuté. La prophylaxie du ROC et la prophylaxie des arythmies cardiaques survenant au cours des corrections de strabisme, sont ainsi placées sur des bases plus rationnelles.

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Copyright information

© Canadian Anesthesiologists 1983

Authors and Affiliations

  • Victor Faria Blanc
    • 1
  • Jean-François Hardy
    • 1
  • Jean Milot
    • 1
  • Jean-Louis Jacob
    • 1
  1. 1.Departments of Anaesthesia and OphthalmologyHôpital Sainte-Justine and Université de MontréalMontréalCanada

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