title: Peribulbar anaesthesia: failure to abolish the oculocardiac reflex.
abstract: Peribulbar anaesthesia is a form of regional anaesthesia which has been used with increasing popularity in cataract surgery. Recently indications for its use have been extended to include surgery for vitreo-retinal disease and strabismus. This study shows that in nine of 11 patients in whom the oculocardiac reflex was stimulated by traction on an extra-ocular muscle, peribulbar anaesthesia failed to abolish the reflex. In each of these patients, the reflex manifested as a bradycardia. In one subject, the bradycardia was profound, showing no QRS complex for five seconds. We recommend that cardiac rhythm be monitored throughout procedures performed under peribulbar anaesthesia, and that a vagolytic agent be available for immediate use.
authors.affiliation: St Paul's Eye Hospital, Liverpool.
authors.forename: M
authors.initials: M
authors.lastname: Batterbury
authors.forename: D
authors.initials: D
authors.lastname: Wong
authors.forename: R
authors.initials: R
authors.lastname: Williams
authors.forename: J
authors.initials: J
authors.lastname: Kelly
authors.forename: S M
authors.initials: SM
authors.lastname: Mostafa
mesh_terms: D000765:Anesthesia, Conduction; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008012:Lidocaine / Q000494:pharmacology*; D013508:Ophthalmologic Surgical Procedures; D012024:Reflex, Oculocardiac / Q000187:drug effects*; D014143:Traction
chemical_list: D008012:Lidocaine