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Ventilation and the oculocardiac reflex
Author(s) -
MIRAKHUR R. K.,
SHEPHERD W. F. I.,
JONES C. J.
Publication year - 1986
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.1986.tb13125.x
Subject(s) - medicine , oculocardiac reflex , anesthesia , heart rate , reflex , ventilation (architecture) , vagovagal reflex , controlled ventilation , blood pressure , engineering , mechanical engineering
Summary A randomised prospective study was carried out in children undergoing surgery for squint correction, to determine the value of controlled ventilation as a prophylaxis against the occurrence of the oculocardiac reflex. One hundred patients anaesthetised with nitrous oxideloxygen and halothane were randomly assigned to either ventilated or spontaneously breathing groups of 50 each. Half the patients in each group received glycopyrronium 7.5 μg/kg intravenously at the time of induction of anaesthesia. Heart rate, rhythm, blood pressure and end tidal CO 2 concentration were monitored throughout. A positive oculocardiac reflex. defined as a fall in heart rate of 20% or more and/or the occurrence of dysrhythmias, was observed in 72% of spontaneously breathing patients and in 100% of ventilated patients not receiving prophylactic intravenous glycopyrronium. The incidence of a positive reflex in patients receiving glycopyrronium was 10% (4 and 16% respectively in spontaneously breathing and ventilated patients). It is concluded that controlled ventilation is of no value as a preventive measure against the occurrence of the oculocardiac reflex in patients undergoing squint surgery and that prophylaxis is safely achieved with the use of intravenous glycopyrronium.