Effects of locally applied lidocaine or ropivacaine on occulocardiac reflex in pediatric strabismus surgery

ABSTRACT

Thirty children aged from 3-14 years, ASA I or II, requiring the correction of strabismus under general anesthesia were included in this study. A preoperative assessment was performed, the children were fasted for 6-8 hours from solid food and 3-4 hours for clear liquid. No premeditation was given. Anesthesia was induced by thiopentone 3-5 mg/kg and tracheal intubation was facilitated by atracurium 0.5-0.6 mg/kg and anesthesia was maintained with N2O oxygen 21 with the addition of isoflurane 0.6-1%. Controlled ventilation was used to maintain end-tidal carbon dioxide [EtCO2] at an accepted level. The patients were randomly categorized into three groups [10 patients each] according to the drug applied locally on the extra ocular muscle as follows Group I [control group] received saline, group II [lidocaine group] received 1 mg/kg lidocaine [2%] and group III [ropivacaine group] received ropivacaine [0.75%] 1 mg/kg [4-5 ml volume]. It was concluded that lidocaine and ropivacaine [in a dose of 1 mg/kg] applied locally to the extra ocular muscles can be used to reduce the incidence of the oculocardiac reflex [OCR] during strabismus surgery in children