Peribulbar anaesthesia: failure to abolish the oculocardiac reflex.
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.
Batterbury
M
M
St Paul's Eye Hospital, Liverpool.
Wong
D
D
Williams
R
R
Kelly
J
J
Mostafa
S M
SM
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
D008012:Lidocaine