Abstract
Purpose
To investigate the incidence of the oculocardiac reflex (OCR), and of postoperative nausea and vomiting (PONV) in adults undergoing strabismus surgery.
Methods
Adults (18 86 yr) undergoing inpatient strabismus surgery received 10 μg·kg atropine and 10 μg·kg alfentaniliv and were randomly allocated to: (A) 5 mg·kg−1 thiopentoneiv, isoflurane/N2O maintenance; (B) 3 mg·kg−1 propofoliv. propofol/N2O maintenance (10–14 mg·kg−1hr·t-1); © 3 mg·kg−1 propofoliv, propofol/air/O2 maintenance (10–14 mg·kg−1·hr−1). Analyses were with the number-needed-to-treat/harm.
Results
In 97 adults the absolute nsk of OCR (13–20%) and PONV (21–31% after 24 hr) was low. with no differences between groups. Number-needed-to-treat to prevent PONV with propofol with or without N2O compared with thiopentone-isoflurane was 7 to 11. Number-needed-to-harm for one OCR with propofol compared with thiopentone-isoflurane was 17.
Conclusion
Adults undergoing strabismus surgery with prophylactic atropine had a low risk of OCR and PONV independent of the anaesthetic technique used.
Résumé
Objectif
Rechercher l’incidence du réflexe oculocardiaque (ROC) et des nausées et vomissements postopératoires (NVPO) chez les adultes opérés pour correction de strabisme.
Méthodes
Des adultes programmés pour une correction de strabisme ont reçu atropine 10 mg·kg−1 et alfentanil 10 μg·kiv et ont été repartis au hasard pour recevoir: (A) thiopentone 5 mgiv. entretien isoflurane/N2O; (B) propofol 3 mg·kgiv, entretien propofol/N2O (10–14 mg·kg−1·h−1); (C) propofol 3 mg·kg−1·h−1 iv. entretien propofol/air/O (10 14 mg·kg−1·h−1). La méthode du nombre de patients à traiter pour prévenir une complication a servi à l’analyse des résultats.
Résultats
Chez 97 adultes, le risque absolu de ROC (13–20%) et de NVPO (21–31% après 24 h) était faible et ne différant pas entre les groupes. Comparativement au thropentone/isoflurane. avec le propofol avec ou sans N2O. le nombre de patients traités pour prévenir un épisode de NVPO était de 7 à II. Avec le propofol. ce nombre appliqué à un épisode de ROC comparativement au thiopentone-isoflurane était de 17.
Conclusion
Les adultes opérés pour strabisme qui recevaient préventivement de l’atropine avaient un risque faible de ROC et de NVPO indépendant de la technique anesthésique.
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Tramèr, M.R., Fuchs-Buder, T., Sansonetti, A. et al. Low incidence of the oculocardiac reflex and postoperative nausea and vomiting in adults undergoing strabismus surgery. Can J Anaesth 44, 830–835 (1997). https://doi.org/10.1007/BF03013159
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DOI: https://doi.org/10.1007/BF03013159