scholarly journals Oculocardiac reflex and oculorespiratory reflex during strabismus surgery under general anesthesia using the laryngeal mask airway with maintenance of spontaneous respiration: A retrospective study

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052094515
Author(s):  
Sun Young Shin ◽  
Min Ju Kim ◽  
Jin Joo
Keyword(s):  
Laryngeal Mask Airway ◽  
Medical Records ◽  
Pediatric Patients ◽  
Strabismus Surgery ◽  
Adult Patients ◽  
Laryngeal Mask ◽  
Spontaneous Respiration ◽  
Depth Of Anesthesia ◽  
Oculocardiac Reflex ◽  
Specific Muscle

Objective To determine (1) how the specific muscle undergoing surgical treatment affects the occurrence of the oculocardiac reflex (OCR) and oculorespiratory reflex (ORR) and (2) whether the depth of anesthesia influences the occurrence of the OCR and ORR in patients undergoing strabismus surgery with a laryngeal mask airway with maintenance of spontaneous respiration. Methods The medical records of patients who underwent strabismus surgery on the lateral rectus (LR) and medial rectus (MR) muscles from January 2017 to December 2017 were retrospectively reviewed. Results The incidence of the OCR was not significantly different between LR and MR operations in either pediatric or adult patients. The incidence of the ORR as indexed by the tidal volume (TV) was significantly higher during MR than LR surgery in pediatric patients (29.3% vs. 10.1%, respectively). The change in TV during muscle traction and the bispectral index were significantly correlated in both pediatric and adult patients (r2 = 0.034 and 0.058, respectively). Conclusions The OCR was not influenced by the specific muscle undergoing surgery or the depth of anesthesia. The incidence of the ORR as indexed by the TV was higher during MR surgery in pediatric patients and was positively correlated with the depth of anesthesia.

scholarly journals Oculocardiac and Oculorespiratory Reflex during Strabismus Surgery under General Anesthesia with Laryngeal Mask Airway for Maintaining Spontaneous Respiration: A Retrospective Study

2019 ◽  
Author(s):  
Sun Young Shin ◽  
Min Ju Kim ◽  
Jin Joo
Keyword(s):  
Laryngeal Mask Airway ◽  
General Anesthesia ◽  
Pediatric Patients ◽  
Strabismus Surgery ◽  
Adult Patients ◽  
Laryngeal Mask ◽  
Spontaneous Respiration ◽  
Anesthesia Induction ◽  
Depth Of Anesthesia ◽  
Specific Muscle

Abstract Background: The oculocardiac reflex (OCR) is defined as a 10–20% reduction in heart rate (HR) from the baseline value or dysrhythmia, and the oculorespiratory reflex (ORR) manifests as shallow respiratory movement and bradypnea caused by manipulation of the eye. The aim of this study was to elucidate whether the specific muscle operated on has an effect on OCR and ORR, as well as whether the depth of anesthesia influences the OCR and ORR in patients undergoing strabismus surgery with laryngeal mask airway (LMA) to maintain spontaneous respiration. Methods: The medical records of patients who underwent strabismus surgery on lateral rectus (LR) and medial rectus (MR) muscles from January 2017 to December 2017 were reviewed. For anesthesia induction, propofol was administered and the LMA was inserted. Anesthesia was maintained with sevoflurane and spontaneous respiration. Results: The incidences of OCR during LR and MR operations were not significantly different between pediatric and adult patients (29% vs 27% and 15% vs 16%, respectively, p < 0.05). The incidence of ORR, as indexed by tidal volume (TV), was higher during MR surgery than during LR surgery in pediatric patients (29.3% vs 10.1%, p < 0.05). The change in HR during muscle traction and bispectral index (BIS) showed a negative correlation in pediatric patients, but this was not statistically significant. The change in TV during muscle traction and BIS was significantly correlated, in both pediatric and adult patients (r2 = 0.034 and 0.058, respectively, p < 0.05), while the change in respiratory rate (RR) during muscle traction and BIS did not show a significant correlation in either group. Conclusions: The incidence rate of OCR did not differ between LR and MR surgeries, and the depth of anesthesia did not correlate with HR changes during muscle traction. Young age and MR surgery may be risk factors for ORR. However, MV did not decrease because of the increased RR during muscle traction. Thus, maintenance of spontaneous respiration with an LMA is safe during strabismus surgery under general anesthesia for both pediatric and adult patients.

Peribulbar anesthesia for strabismus surgery in adult patients

2020 ◽  
pp. 112067212097494
Author(s):  
Aldo Vagge ◽  
Franco Simonetti ◽  
Maria Marenco ◽  
Carmen Burtolo ◽  
Maria Musolino ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Medical Records ◽  
Strabismus Surgery ◽  
Adult Patients ◽  
Study Group ◽  
Efficacy And Safety ◽  
Oculocardiac Reflex ◽  
Peribulbar Block ◽  
Peribulbar Anesthesia ◽  
Intravenous Atropine

Purpose: To evaluate the efficacy and safety of peribulbar anesthesia during strabismus surgery. Methods: Medical records of patients undergoing strabismus surgery and peribulbar anesthesia were reviewed. The overall efficacy of peribulbar anesthesia was evaluated as requirement of supplemental peribulbar anesthesia, impossibility to perform eye muscles surgery due to inadequate efficacy of the block and peribulbar block complications that occurred up to 6 weeks postoperatively. Presence of oculocardiac reflex (OCR) and presence of decreased visual acuity and afferent pupillary defect postoperatively were reported. Results: A total of 510 patients comprised our study group. The total amount of peribulbar injections was 717. Four patients (0.7%) required supplemental injection in the superonasal quadrant. Five of 510 (0.9%) required an anesthesiologic intervention with intravenous atropine. Eighty patients of 510 (15.6%) complained about transitory complete ptosis and/or amaurosis postoperatively. No complications were observed up to 6 weeks postoperatively. Conclusion: Peribulbar anesthesia was an effective and safe option during strabismus surgery in adult patients.

Remifentanil Halves the EC50 of Propofol for Successful Insertion of the Laryngeal Mask Airway and Laryngeal Tube in Pediatric Patients

2007 ◽  
Vol 105 (1) ◽  
pp. 57-61 ◽  
Author(s):  
Hye-Jin Park ◽  
Jeong-Rim Lee ◽  
Chong Sung Kim ◽  
Seong Deok Kim ◽  
Hee-Soo Kim
Keyword(s):  
Laryngeal Mask Airway ◽  
Pediatric Patients ◽  
Laryngeal Tube ◽  
Laryngeal Mask

A Comparison of the Disposable Versus the Reusable Laryngeal Mask Airway in Paralyzed Adult Patients

1998 ◽  
Vol 87 (4) ◽  
pp. 921-924 ◽  
Author(s):  
Joseph Brimacombe ◽  
Christian Keller ◽  
Rebecca Morris ◽  
D. Mecklem
Keyword(s):  
Laryngeal Mask Airway ◽  
Adult Patients ◽  
Laryngeal Mask

scholarly journals Anaesthesia for Tracheobronchial Stent Insertion Using an Laryngeal Mask Airway and High-Frequency Jet Ventilation

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Anne M. Dolan ◽  
Michael F. Moore
Keyword(s):  
Laryngeal Mask Airway ◽  
High Frequency ◽  
Malignant Tumour ◽  
Laryngeal Mask ◽  
Spontaneous Respiration ◽  
Stent Insertion ◽  
Jet Ventilation ◽  
High Frequency Jet Ventilation ◽  
Tracheobronchial Stent ◽  
Surgical Field

An approach which promotes a rapid return to spontaneous respiration after tracheobronchial stent (TBS) insertion is considered the optimal one and is a belief shared by anaesthetists, respiratory physicians, and surgeons alike (Calvey and William (2008)). The value of the laryngeal mask airway (LMA), followed by use of the Monsoon 111 Acutronic jet ventilator pressure limiting system of ventilation, for the deployment of stents in the three individual cases that of tracheoesophageal fistula, a bronchoesophageal fistula, and tracheal compression from an invading oesophageal malignant tumour are reported. The roles of target controlled anaesthesia, high-frequency jet ventilation (HFJV), and the laryngeal mask airway in optimising the surgical field and reducing the risk of bronchospasm at emergence are advantages of this technique.

Factors Affecting Oculocardiac Reflex Incidence In Pediatric Strabismus Surgery: Retrospective Study

2021 ◽  
Author(s):  
Bengü Gülhan Aydın ◽  
Gamze Küçükosman ◽  
Özcan Pişkin ◽  
Bahar Aktaş ◽  
Rahşan Dilek Okyay ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pediatric Patients ◽  
Sinus Bradycardia ◽  
Strabismus Surgery ◽  
Neuromuscular Blocker ◽  
Anesthesia Induction ◽  
Factors Affecting ◽  
Oculocardiac Reflex ◽  
Anesthetic Drugs ◽  
Duration Of Surgery

INTRODUCTION: Oculocardiac reflex (OCR) activation is common during the strabismus surgery. As a result of the OCR, sinus bradycardia, atrioventricular block, ventricular fibrillation and even asystole may occur. Pediatric patients are also more vulnerable to harmful effects of this reflex. The aim of this study was to determine the possible risk factors affecting the incidence of OCR in pediatric patients undergoing strabismus surgery. METHODS: The medical records of the pediatric patients who underwent strabismus surgery between January 2015 and September 2018 were retrospectively reviewed. Operations performed by only one surgeon. OCR was defined as a more than 20% reduction in HR induced by the extraocular muscle (EOM) manipulation. Demographic data, duration of surgery, history of any previous strabismus surgery and possible development of OCR, anesthesia management, neuromuscular blocker and anesthetic drugs used for the anesthesia induction and maintenance as well as the airway management, the number of operated eyes, and also the muscle types of the patients were all recorded. Risk factors for OCR were evaluated by logistic regression analysis. RESULTS: Out of 92 pediatric patients who were initially evaluated, six were excluded from the study because their files were missing. A total of 86 patients were included in the study. During surgery, OCR occurred in 29 (33.7%) patients. The absence of administering benzodiazepine for premedication (p=0.03) and neuromuscular blocker after induction (p=0.046) in pediatric patients are specified as independent risk factors. We found that the use of a neuromuscular blocker and benzodiazepine in premedication reduced the risk of OCR by 3.64 and 3.11 times, respectively. DISCUSSION AND CONCLUSION: The incidence of OCR may decrease with preventive measures such as neuromuscular blocker application, premedication with benzodiazepine in strabismus surgeries.

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