Clinical Analysis of the Effects of Glycopyrrolate and Atropine on Oculocardiac Reflex(OCR)

ABSTRACT

The objectives of this study were to investigate and compare the efficacy for glycopyrrolate and atropine in the suppression of the OCR. Preoperative medication of the glycopyrrolate and atropine were studied in 114 pediatric patients for adequate prevention of the OCR. The results obtained were summarized as follows. 1) OCR occurred in 31.8% in Group I(use of atropine) and in 31.3% in Group II(use of Glycopyrrolate). 2) Traction on the extraocular muscles, particularly the medial or lateral rectus muscles most likely elicit the OCR, but there was not a significant difference in occurance of the PCR during each muscle traction. 3) There is great individual variation in response to muscle traction with in each group, no group was fully protected from marked slowing in heart rate. 4) The use of intramuscular administration of atropine or glycopyrrolate prior to induction has not been found to decrease the incidence of the reflex. 5) The dysrhythmias of the OCR were bradycardia, bigeminy, nodal rhythms, and ectopic beats.