Effect of different anaesthetic regimes on the oculocardiac reflex during paediatric strabismus surgery
The oculocardiac reflex (OCR) is induced by mechanical stimulation and therefore is frequently encountered during strabismus surgery. This study was designed to determine how various anaesthetic regimes modulate the haemodynamic effects of the OCR during paediatric strabismus surgery. Thirty‐nine pa...
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| Veröffentlicht in: | Paediatric anaesthesia (Paris) 2000-11, Vol.10 (6), p.601-608 |
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| description | The oculocardiac reflex (OCR) is induced by mechanical stimulation and therefore is frequently encountered during strabismus surgery. This study was designed to determine how various anaesthetic regimes modulate the haemodynamic effects of the OCR during paediatric strabismus surgery. Thirty‐nine patients (4–14 years, ASA I) were randomized to one of four anaesthetic regimes: group P: propofol (12 mg·kg–1·h–1) and alfentanil (0.04 mg·kg–1·h–1); group S: sevoflurane 1–1.2 MAC in 30% O2/70% N2O; group K: ketamine racemate (10–12 mg·kg–1·h–1) and midazolam (0.3–0.6 mg·kg–1·h–1; group H: halothane 1–1.2 MAC in 30% O2/70% N2O. Electrocardiogram (ECG), beat‐to‐beat heart rate (HR) and blood pressure (BP) changes were measured during and after a standardized traction was applied to an external eye muscle (4–6 Newton, 90 s). OCR was defined as a 10% change in HR induced by traction. OCR occurred in 77% of patients. Whereas virtually all patients in the P, H and S groups developed OCR, only 22% developed it in group K. Median HR change in group P (–37 bpm) was significantly greater (P |
| doi_str_mv | 10.1111/j.1460-9592.2000.00588.x |
| format | Article |
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This study was designed to determine how various anaesthetic regimes modulate the haemodynamic effects of the OCR during paediatric strabismus surgery. Thirty‐nine patients (4–14 years, ASA I) were randomized to one of four anaesthetic regimes: group P: propofol (12 mg·kg–1·h–1) and alfentanil (0.04 mg·kg–1·h–1); group S: sevoflurane 1–1.2 MAC in 30% O2/70% N2O; group K: ketamine racemate (10–12 mg·kg–1·h–1) and midazolam (0.3–0.6 mg·kg–1·h–1; group H: halothane 1–1.2 MAC in 30% O2/70% N2O. Electrocardiogram (ECG), beat‐to‐beat heart rate (HR) and blood pressure (BP) changes were measured during and after a standardized traction was applied to an external eye muscle (4–6 Newton, 90 s). OCR was defined as a 10% change in HR induced by traction. OCR occurred in 77% of patients. Whereas virtually all patients in the P, H and S groups developed OCR, only 22% developed it in group K. Median HR change in group P (–37 bpm) was significantly greater (P < 0.05) than in group H (–17 bpm) or group K (–7 bpm). Median BP change in group K (+10 mmHg) was significantly different (P < 0.05) from group H (–5 mmHg), group S (–3 mmHg) and group P (–8 mmHg). Atrioventricular rhythm disorders were significantly more frequent in group P compared with group K (P < 0.02). Respiration‐induced sinus dysrhythmia was significantly less frequent (P < 0.001) in group K (0%), compared with group P (100%), group H (56%) and group S (55%). Of the anaesthetic techniques studied, ketamine anaesthesia is associated with the least haemodynamic changes induced by OCR during strabismus surgery in paediatric patients.</description><identifier>ISSN: 1155-5645</identifier><identifier>EISSN: 1460-9592</identifier><identifier>DOI: 10.1111/j.1460-9592.2000.00588.x</identifier><identifier>PMID: 11119192</identifier><language>eng</language><publisher>Oxford UK: Blackwell Science Ltd</publisher><subject>Adolescent ; anaesthetics ; Anesthesia ; Anesthesia depending on type of surgery ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Anesthetics - pharmacology ; Anesthetics, Combined - pharmacology ; Biological and medical sciences ; Child ; Child, Preschool ; Female ; Hemodynamics - drug effects ; Humans ; ketamine ; Male ; Medical sciences ; oculocardiac reflex ; Orthopedic surgery. Maxillofacial surgery. Otorhinolaryngologic surgery. Stomatology. Ophtalmology. Investigation and treatment technics ; pharmacological effects ; Physical Stimulation ; Reflex, Oculocardiac - drug effects ; Strabismus - surgery</subject><ispartof>Paediatric anaesthesia (Paris), 2000-11, Vol.10 (6), p.601-608</ispartof><rights>2001 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3458-27d4ce8cd66436da9b96e61369750a4cd1cc00b46007a49e3e4c7f96790aa55f3</citedby><cites>FETCH-LOGICAL-c3458-27d4ce8cd66436da9b96e61369750a4cd1cc00b46007a49e3e4c7f96790aa55f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1460-9592.2000.00588.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1460-9592.2000.00588.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>309,310,314,780,784,789,790,1417,23930,23931,25140,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=805716$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11119192$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>HAHNENKAMP, KLAUS</creatorcontrib><creatorcontrib>HÖNEMANN, CHRISTIAN W.</creatorcontrib><creatorcontrib>FISCHER, LARS G.</creatorcontrib><creatorcontrib>DURIEUX, MARCEL E.</creatorcontrib><creatorcontrib>MUEHLENDYCK, HERMANN</creatorcontrib><creatorcontrib>BRAUN, ULRICH</creatorcontrib><title>Effect of different anaesthetic regimes on the oculocardiac reflex during paediatric strabismus surgery</title><title>Paediatric anaesthesia (Paris)</title><addtitle>Paediatr Anaesth</addtitle><description>The oculocardiac reflex (OCR) is induced by mechanical stimulation and therefore is frequently encountered during strabismus surgery. This study was designed to determine how various anaesthetic regimes modulate the haemodynamic effects of the OCR during paediatric strabismus surgery. Thirty‐nine patients (4–14 years, ASA I) were randomized to one of four anaesthetic regimes: group P: propofol (12 mg·kg–1·h–1) and alfentanil (0.04 mg·kg–1·h–1); group S: sevoflurane 1–1.2 MAC in 30% O2/70% N2O; group K: ketamine racemate (10–12 mg·kg–1·h–1) and midazolam (0.3–0.6 mg·kg–1·h–1; group H: halothane 1–1.2 MAC in 30% O2/70% N2O. Electrocardiogram (ECG), beat‐to‐beat heart rate (HR) and blood pressure (BP) changes were measured during and after a standardized traction was applied to an external eye muscle (4–6 Newton, 90 s). OCR was defined as a 10% change in HR induced by traction. OCR occurred in 77% of patients. Whereas virtually all patients in the P, H and S groups developed OCR, only 22% developed it in group K. Median HR change in group P (–37 bpm) was significantly greater (P < 0.05) than in group H (–17 bpm) or group K (–7 bpm). Median BP change in group K (+10 mmHg) was significantly different (P < 0.05) from group H (–5 mmHg), group S (–3 mmHg) and group P (–8 mmHg). Atrioventricular rhythm disorders were significantly more frequent in group P compared with group K (P < 0.02). Respiration‐induced sinus dysrhythmia was significantly less frequent (P < 0.001) in group K (0%), compared with group P (100%), group H (56%) and group S (55%). Of the anaesthetic techniques studied, ketamine anaesthesia is associated with the least haemodynamic changes induced by OCR during strabismus surgery in paediatric patients.</description><subject>Adolescent</subject><subject>anaesthetics</subject><subject>Anesthesia</subject><subject>Anesthesia depending on type of surgery</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Anesthetics - pharmacology</subject><subject>Anesthetics, Combined - pharmacology</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Female</subject><subject>Hemodynamics - drug effects</subject><subject>Humans</subject><subject>ketamine</subject><subject>Male</subject><subject>Medical sciences</subject><subject>oculocardiac reflex</subject><subject>Orthopedic surgery. Maxillofacial surgery. Otorhinolaryngologic surgery. Stomatology. Ophtalmology. Investigation and treatment technics</subject><subject>pharmacological effects</subject><subject>Physical Stimulation</subject><subject>Reflex, Oculocardiac - drug effects</subject><subject>Strabismus - surgery</subject><issn>1155-5645</issn><issn>1460-9592</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkMlu2zAQhokgRZKmfYWAQIDcpJISFxHoJQjStIWR9tAlN2JMjRy6WlxSQu23L1Ub7jW8cDDz_bP8hFDOcp7eu3XOhWKZkabIC8ZYzpisqnx7Qi6OhdMUcykzqYQ8J69jXDPGy0IVZ-R8bmK4KS7I6r5p0I10aGjtUxiwHyn0gHF8xtE7GnDlO4x06GnK0MFN7eAg1B7mWtPiltZT8P2KbgBTdgxJFMcASx-7KdI4hRWG3RvyqoE24tvDf0m-f7j_dvcxW3x5-HR3u8hcKWSVFboWDitXKyVKVYNZGoWKl8poyUC4mjvH2DLdyDQIgyUKpxujtGEAUjblJbnZ992E4feUrrCdjw7bFnocpmh1ISomOUtgtQddGGJMl9hN8B2EneXMzv7YtZ29tLOXdjbZ_jPZbpP06jBjWnZY_xceXE3A9QGA6KBtAvTOxyOXFtBcJer9nvrjW9y9eLz9evuYgiTP9nIfR9we5RB-WaVLLe3Pxwf7o1JPwnxe2KfyL4COp7U</recordid><startdate>200011</startdate><enddate>200011</enddate><creator>HAHNENKAMP, KLAUS</creator><creator>HÖNEMANN, CHRISTIAN W.</creator><creator>FISCHER, LARS G.</creator><creator>DURIEUX, MARCEL E.</creator><creator>MUEHLENDYCK, HERMANN</creator><creator>BRAUN, ULRICH</creator><general>Blackwell Science Ltd</general><general>Blackwell</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200011</creationdate><title>Effect of different anaesthetic regimes on the oculocardiac reflex during paediatric strabismus surgery</title><author>HAHNENKAMP, KLAUS ; HÖNEMANN, CHRISTIAN W. ; FISCHER, LARS G. ; DURIEUX, MARCEL E. ; MUEHLENDYCK, HERMANN ; BRAUN, ULRICH</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3458-27d4ce8cd66436da9b96e61369750a4cd1cc00b46007a49e3e4c7f96790aa55f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Adolescent</topic><topic>anaesthetics</topic><topic>Anesthesia</topic><topic>Anesthesia depending on type of surgery</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Anesthetics - pharmacology</topic><topic>Anesthetics, Combined - pharmacology</topic><topic>Biological and medical sciences</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Female</topic><topic>Hemodynamics - drug effects</topic><topic>Humans</topic><topic>ketamine</topic><topic>Male</topic><topic>Medical sciences</topic><topic>oculocardiac reflex</topic><topic>Orthopedic surgery. Maxillofacial surgery. Otorhinolaryngologic surgery. Stomatology. Ophtalmology. Investigation and treatment technics</topic><topic>pharmacological effects</topic><topic>Physical Stimulation</topic><topic>Reflex, Oculocardiac - drug effects</topic><topic>Strabismus - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>HAHNENKAMP, KLAUS</creatorcontrib><creatorcontrib>HÖNEMANN, CHRISTIAN W.</creatorcontrib><creatorcontrib>FISCHER, LARS G.</creatorcontrib><creatorcontrib>DURIEUX, MARCEL E.</creatorcontrib><creatorcontrib>MUEHLENDYCK, HERMANN</creatorcontrib><creatorcontrib>BRAUN, ULRICH</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Paediatric anaesthesia (Paris)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>HAHNENKAMP, KLAUS</au><au>HÖNEMANN, CHRISTIAN W.</au><au>FISCHER, LARS G.</au><au>DURIEUX, MARCEL E.</au><au>MUEHLENDYCK, HERMANN</au><au>BRAUN, ULRICH</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of different anaesthetic regimes on the oculocardiac reflex during paediatric strabismus surgery</atitle><jtitle>Paediatric anaesthesia (Paris)</jtitle><addtitle>Paediatr Anaesth</addtitle><date>2000-11</date><risdate>2000</risdate><volume>10</volume><issue>6</issue><spage>601</spage><epage>608</epage><pages>601-608</pages><issn>1155-5645</issn><eissn>1460-9592</eissn><abstract>The oculocardiac reflex (OCR) is induced by mechanical stimulation and therefore is frequently encountered during strabismus surgery. This study was designed to determine how various anaesthetic regimes modulate the haemodynamic effects of the OCR during paediatric strabismus surgery. Thirty‐nine patients (4–14 years, ASA I) were randomized to one of four anaesthetic regimes: group P: propofol (12 mg·kg–1·h–1) and alfentanil (0.04 mg·kg–1·h–1); group S: sevoflurane 1–1.2 MAC in 30% O2/70% N2O; group K: ketamine racemate (10–12 mg·kg–1·h–1) and midazolam (0.3–0.6 mg·kg–1·h–1; group H: halothane 1–1.2 MAC in 30% O2/70% N2O. Electrocardiogram (ECG), beat‐to‐beat heart rate (HR) and blood pressure (BP) changes were measured during and after a standardized traction was applied to an external eye muscle (4–6 Newton, 90 s). OCR was defined as a 10% change in HR induced by traction. OCR occurred in 77% of patients. Whereas virtually all patients in the P, H and S groups developed OCR, only 22% developed it in group K. Median HR change in group P (–37 bpm) was significantly greater (P < 0.05) than in group H (–17 bpm) or group K (–7 bpm). Median BP change in group K (+10 mmHg) was significantly different (P < 0.05) from group H (–5 mmHg), group S (–3 mmHg) and group P (–8 mmHg). Atrioventricular rhythm disorders were significantly more frequent in group P compared with group K (P < 0.02). Respiration‐induced sinus dysrhythmia was significantly less frequent (P < 0.001) in group K (0%), compared with group P (100%), group H (56%) and group S (55%). Of the anaesthetic techniques studied, ketamine anaesthesia is associated with the least haemodynamic changes induced by OCR during strabismus surgery in paediatric patients.</abstract><cop>Oxford UK</cop><pub>Blackwell Science Ltd</pub><pmid>11119192</pmid><doi>10.1111/j.1460-9592.2000.00588.x</doi><tpages>8</tpages></addata></record> |
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| subjects | Adolescent anaesthetics Anesthesia Anesthesia depending on type of surgery Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Anesthetics - pharmacology Anesthetics, Combined - pharmacology Biological and medical sciences Child Child, Preschool Female Hemodynamics - drug effects Humans ketamine Male Medical sciences oculocardiac reflex Orthopedic surgery. Maxillofacial surgery. Otorhinolaryngologic surgery. Stomatology. Ophtalmology. Investigation and treatment technics pharmacological effects Physical Stimulation Reflex, Oculocardiac - drug effects Strabismus - surgery |
| title | Effect of different anaesthetic regimes on the oculocardiac reflex during paediatric strabismus surgery |
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