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Korean J Anesthesiol > Volume 37(6); 1999 > Article
Korean Journal of Anesthesiology 1999;37(6):1046-1053.
DOI: https://doi.org/10.4097/kjae.1999.37.6.1046   
Oculocardiac Reflex and Postoperative Recovery in Pediatric Strabismus Surgery: A Randomized Trial Comparing Four Anesthetic Techniques.
Jeong Yeon Hong, Hae Keum Kil
1Department of Anesthesiology, Sungkyunkwan University School of Medicine.
2Department of Anesthesiology, Yonsei University College of Medicine.
Oculocardiac reflex (OCR) and postoperative nausea/vomiting are major complications of pediatric strabismus surgery. The aim of the study was to assess, in children undergoing strabismus surgery, the incidence of OCR and postoperative emesis with a inhalational and a intravenous technique.
44 healthy children undergoing elective strabismus surgery as inpatients were randomly allocated to four anesthetic techniques: (1) induction with propofol, maintenance with propofol infusion and 50% N2O-O2 (propofol-N2O); (2) induction with propofol and fentanyl 1 microgram/kg bolus, maintenance with propofol infusion and 50% air-O2 (propofol-fentnyl-air); (3) induction with thiopental, maintenance with enflurane and 50% N2O-O2 (enflurane-N2O); (4) induction with thiopental and fentanyl 1 microgram/kg, maintenance with enflurane and 50% air-O2 (enflurane-fentanyl-air).
The incidence of an OCR significantly increased in the propofol-fentanyl-air group as compared to the enflurane-N2O or enflurane-fentanyl-air groups. Times to extubation were shorter in the propofol- N2O group than in the propofol-fentanyl-air or enflurane-fentanyl-air groups. Alertness scores were lower in the propofol-N2O group than in the enflurane-N2O or enflurane-fentanyl-air groups. Postanesthetic recovery scores and nausea/vomiting during the 24 hr after the operation did not show any differences among the groups.
We concluded that children undergoing strabismus surgery anesthetized with propofolfentanyl-air had more episodes of OCR, propofol-N2O had shorter times to extubation and higher alertness scores, and the addition of N2O or fentanyl to anesthetic regimen was not associated with nausea and vomiting.
Key Words: Anesthetics, intravenous, fentanyl, propofol; Anesthetics, volatile, enflurane; Complication, oculocardiac reflex, vomiting; Surgery, strabismus
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