Anesthetics usually check for BP and pulse when ophthalmologist maneuvers medial rectus muscle in squint surgery. This is to prevent?
Ans. is 'c' i.e., Oculocardiac reflex * Oculocardiac reflex is most common in pediatric patients undergoing strabismus surgery. Traction on extraocular muscle (especially medial rectus) causes a wide variety of cardia arrhythmias.Oculocardiac reflex* Traction on the extraocular muscles or pressure on globe (eye ball) causes bradycardia, AV block, ventricular ectopy or asystole. It is especially seen with traction on the medial rectus, but can occur with stimulation of any of the orbital contents, including the periosteum.* The reflex is trigeminovagal, i.e., afferent is via trigeminal and efferent is via vagal pathway.* The oculocardiac reflex is most common in pediatric patients undergoing strabismus surgery. Nonetheless, it can be evoked in all age groups and during a variety of ocular procedures including cataract extraction, enucleation, and retinal detachment repair.* Anticholinergic drugs (atropine, glycopyrrolate) is often helpful in preventing oculocardiac reflex.* Management of oculocardiac reflex includes cessation of surgical stimulus; adequate ventilation, oxygenation & anesthesia; intravenous atropine; infiltration of rectus muscles with local anesthetic.
Vasovagal attack
Hypotension syndrome
Oculocardiac reflex
None
Anaesthesia For Special Situations