Oculocardiac Reflex during Ptosis Operation under Local Anesthesia

ABSTRACT

PURPOSE: To evaluate the incidence and examine the development of oculocardiac reflex during ptosis operation under local anesthesia. METHODS: Twenty-eight patients (52 eyes) who underwent ptosis operation under local anesthesia participated in this prospective study. We examined the change of heart rate. We also investigated the incidence of oculocardiac reflex and analyzed factors associated with it. RESULTS: The mean preoperative heart rate was 76.06+/-11.24 beats/min. During local anesthetic injection, skin incision, traction of the central fat pad, traction of the medial fat pad, traction of the levator palpebrae muscle, the mean heart rates were 74.81+/-12.64 beats/min, 74.73+/-12.20 beats/min, 73.63+/-11.73 beats/min, 73.35+/-12.24 beats/min, 71.44+/-11.93 beats/min respectively. Hence, the mean heart rate decreased during each successive part of the operation. The oculocardiac reflex was positive in 24 (46.2%) of 52 eyes. There was no significant difference between the incidence of oculocardiac reflex in males and females. The incidence of oculocardiac reflex was highest during traction of the levator palpebrae muscle. CONCLUSIONS: During ptosis operation under local anesthesia, oculocardiac reflex can occur. Gentle manipulation of surgical tissues and cardiac monitoring is needed to prevent side effects from oculocardiac reflex.