Document Detail


Effect of different anesthetic agents on oculocardiac reflex in pediatric strabismus surgery.
MedLine Citation:
PMID:  19921355     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The oculocardiac reflex (OCR) occurs frequently during pediatric strabismus surgery. The aim of this study was to assess the effects of various anesthetic regimens on the incidence of OCR during the surgery. METHODS: Two hundred and eighty children, 1 to 9 years old, undergoing elective strabismus surgery, were randomly assigned to eight groups; ketamine-sevoflurane (KS), ketamine-desflurane (KD), ketamine-propofol (KP), ketamine-remifentanil (KR), midazolam-sevoflurane (MS), midazolam-desflurane (MD), midazolam-propofol (MP), and midazolam-remifentanil (MR). No premedication was given. Anesthesia was induced using ketamine 1 mg kg(-1) or midazolam 0.15 mg kg(-1) with 66% N(2)O in O(2). Laryngeal mask airways (LMAs) were placed with rocuronium 0.5 mg kg(-1). Anesthesia was maintained with sevoflurane 2-3 vol. %, desflurane 5-6 vol. %, propofol 7-8 mg kg(-1) h(-1), or remifentanil 0.75 microg kg(-1) over 1 min, followed by a continuous infusion of remifentanil 0.5 microg kg(-1) min(-1) with 66% N(2)O in O(2). Heart rate (HR) was recorded during extraocular muscle (EOM) manipulation. OCR was defined as a reduction in HR of more than 20% induced by the traction of an EOM. RESULTS: In patients given ketamine, OCR occurred more frequently in the KP (65.7%) and KR (62.9%) groups than in the KD (29.4%) and KS (37.1%) groups (P < 0.05). In patients given midazolam, OCR occurred more frequently in the MP (54.3%) and MR (60.6%) groups than in the MD (36.4%) and MS (31.4%) groups (P < 0.05). CONCLUSION: Propofol or remifentanil anesthesia was associated with a higher incidence of OCR during pediatric strabismus surgery than sevoflurane and desflurane anesthesia, when either ketamine or midazolam was used as an induction agent.
Authors:
So Ron Choi; Sang Won Park; Jong Hwan Lee; Seung Cheol Lee; Chan Jong Chung
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2009-11-18
Journal Detail:
Title:  Journal of anesthesia     Volume:  23     ISSN:  1438-8359     ISO Abbreviation:  J Anesth     Publication Date:  2009  
Date Detail:
Created Date:  2009-11-20     Completed Date:  2010-01-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8905667     Medline TA:  J Anesth     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  489-93     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology and Pain Medicine, Dong-A University Hospital, Seo-gu, Busan, Korea.
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MeSH Terms
Descriptor/Qualifier:
Androstanols
Anesthesia*
Anesthesia, General / adverse effects*
Anesthetics / adverse effects*
Anesthetics, Dissociative
Anesthetics, Inhalation
Anesthetics, Intravenous
Child
Child, Preschool
Female
Heart Rate / drug effects
Humans
Infant
Intraoperative Complications / chemically induced*,  epidemiology,  physiopathology*
Isoflurane / analogs & derivatives
Ketamine
Male
Methyl Ethers
Midazolam
Monitoring, Intraoperative
Neuromuscular Blockade
Neuromuscular Nondepolarizing Agents
Ophthalmologic Surgical Procedures*
Reflex, Oculocardiac / drug effects*
Strabismus / surgery*
Chemical
Reg. No./Substance:
0/Androstanols; 0/Anesthetics; 0/Anesthetics, Dissociative; 0/Anesthetics, Inhalation; 0/Anesthetics, Intravenous; 0/Methyl Ethers; 0/Neuromuscular Nondepolarizing Agents; 143558-00-3/rocuronium; 26675-46-7/Isoflurane; 28523-86-6/sevoflurane; 57041-67-5/desflurane; 59467-70-8/Midazolam; 6740-88-1/Ketamine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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