Binocular vision & strabismus quarterly
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Binocul Vis Strabismus Q · Jan 2004
Comparative StudyThe profound augmentation of the oculocardiac reflex by fast acting opioids.
Trigemino-vagal bradycardia elicited by tension on an extraocular muscles (oculocardiac reflex; OCR) is a hazard for strabismus surgery patients. OCR can be reduced by anticholinergic medications and regulating the depth of anesthesia. We investigated the influence of narcotic agents as a routine part of general anesthesia for strabismus surgery in adults and children. ⋯ In the absence of anticholinergic blockade, rapidly acting narcotics enhance the degree of bradycardia due to the OCR elicited by controlled extraocular muscle tension during strabismus surgery. Some opioids had the same augmenting magnitude as the blocking effect of IV anticholinergic medication. Meperidine, which has some anticholinergic characteristics, neither blocked nor augmented the OCR.