A five year old is scheduled for strabismus surgery. As the surgeon grasps medial rectus muscle anesthesiologist carefully monitors the pulse. This is for
Aschners reflex is called oculocardiac reflex. TheOculocardiac reflex, also known asAschner phenomenon, Aschner reflex, or Aschner-Dagnini reflex, is a decrease in pulse rate associated with traction applied to extraocular muscles and/or compression of the eyeball. The reflex is mediated by nerve connections between the ophthalmic branch of the trigeminal cranial nerve the ciliary ganglion, and the vagus nerve of the parasympathetic nervous system. Nerve fibres from the maxillary and mandibular divisions of the trigeminal nerve have also been documented. These afferents synapse with the visceral motor nucleus of the vagus nerve, located in the reticular formation of the brain stem. The efferent poion is carried by the vagus nerve from the cardiovascular centerof the medulla to the hea, of which increased stimulation leads to decreased output of the sinoatrial node. This reflex is especially sensitive in neonates and children, paicularly during strabismus correction surgery.However, this reflex may also occur with adults. Bradycardia, junctional rhythm and asystole all of which may be life-threatening,can be induced through this reflex. This reflex has been seen to occur during many pan facial trauma surgeries due to stimulation of any of the three branches of trigeminal nerve.
Assessing the depth of anesthesia
Detecting Aschners reflex
Rule out ventricular dysrrhythmias
Detecting hypotension
Monitoring in Anesthesia