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Objective To observe the incidence of oculocardiac reflex in cataract surgery and investigate the corresponding measures.Methods One hundred cataract patients with surgical treatment were enrolled in this study,observed the occurrence of oculocardiac reflex in different surgical procedures and taked active preventive measures and first aid.Results The incidence of oculocardiac reflex was 20％(20/100),which the intraoperative effective measures can significantly reduce the incidence of oculocardiac reflex.Conclusion In cataract surgery,the incidence of oculocardiac reflex is not high,but the anesthesiologist must be prepared to work effectively with doctors completed surgery to avoid adverse consequences resulting from oculocardiac reflex.
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Fundamento: el reflejo óculo-cardíaco es un fenómeno muy conocido en la cirugía oftalmológica y desde su descubrimiento los oftalmólogos y anestesiólogos lo consideran como un problema intraoperatorio significativo, describen disritmias que causaron morbosidad y muerte. Objetivo: realizar una revisión sobre las consideraciones anestésicas ante la presencia del reflejo óculo-cardíaco. Método: se realizó una revisión bibliográfica sobre el tema, en el cual se aborda la Anatomía, la Fisiología, las particularidades anestésicas y el tratamiento del mismo una vez presente. Conclusiones: El conocimiento exhaustivo de la ocurrencia del reflejo óculo-cardíaco causará beneficio a los pacientes sometidos a la cirugía oftalmológica.
Background: oculocardiac reflex is a very well-known phenomenon in the ophthalmologic surgery and since its discovery oculists and anesthesiologists consider it as a significant intraoperative problem, they describe dysrhythmia that caused morbidity and death. Objective: to carry out a revision on anesthetic considerations in the face of oculocardiac reflex. Method: a bibliographical revision on the topic, in which is approached anatomy, physiology, anesthetic particularities and treatment once it is presented. Conclusions: The exhaustive knowledge of the occurrence of oculocardiac reflex caused benefit to patients underwent to the ophthalmologic surgery.
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BACKGROUND: Severe bradycardia occurring in strabismus surgery is unpredictable and may lead to cardiac arrest. If we identify patients who have risk of severe bradycardia during strabismus surgery, it is helpful to provide a more meticulous anesthesia. In this study, we investigated the correlation between the degree of bradycardia and indices of power spectral analysis and nonlinear dynamic data analysis of preoperative ECG. METHODS: ECG was collected for twenty minutes from strabismus patients (n = 93). No premedicants were administered. After administration of anesthesia and traction of extraocular muscle, the lowest heart rate was recorded. We calculated the correlation coefficient between the power spectral density, approximate entropy and correlation dimension of preoperative ECG and the difference between preoperative and lowest HR. RESULTS: As the difference between the preoperative heart rate and the intraoperative bradycardia increased, the preoperative ECG showed a low total power (r = 0.27, P = 0.016), low low-frequency power (r = 0.31, P = 0.049), low high-frequency power (r = 0.30, P = 0.007) and high ratio of low to high-frequency power (r = 28, P = 0.03). There was no correlation between bradycardia and approximate entropy and correlation dimension, respectively. CONCLUSIONS: There was a correlation between indices of power spectral analysis of preoperative ECG and degree of bradycardia during strabismus surgery. Therefore we take into consideration preoperative ECG and its analytic indices in order to provide careful preparation for high risk patients who exhibit a tendency to severe bradycardia.
