Low incidence of the oculocardiac reflex and postoperative nausea and vomiting in adults undergoing strabismus surgery.
OBJECTIVE
To investigate the incidence of the oculocardiac reflex (OCR), and of postoperative nausea and vomiting (PONV) in adults undergoing strabismus surgery.


METHODS
Adults (18-86 yr) undergoing inpatient strabismus surgery received 10 micrograms.kg-1 atropine and 10 micrograms.kg-1 altentanil iv and were randomly allocated to: (A) 5 mg.kg-1 thiopentone iv, isoflurane/N2O maintenance; (B) 3 mg.kg-1 propofol iv, propofol/N2O maintenance (10-14 mg.kg-1.hr-1); 3 mg.kg-1 propofol iv, propofol/air/O2 maintenance (10-14 mg.kg-1.hr-1). Analyses were with the number-needed-to-treat/harm.


RESULTS
In 97 adults the absolute risk of OCR (13-20%) and PONV (21-31% after 24 hr) was low, with no differences between groups. Number-needed-to-treat to prevent PONV with propofol with or without N2O compared with thiopentone-isoflurane was 7 to 11. Number-needed-to-harm for one OCR with propofol compared with thiopentone-isoflurane was 17.


CONCLUSIONS
Adults undergoing strabismus surgery with prophylactic atropine had a low risk of OCR and PONV, independent of the anaesthetic technique used.
Tramèr
M R
MR
Department of Anaesthesiology, Clinical Pharmacology and Surgical Intensive Care, University Hospital Geneva, Switzerland.
Fuchs-Buder
T
T
Sansonetti
A
A
Rifat
K
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001285:Atropine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000453:epidemiology*; D011183:Postoperative Complications / Q000453:epidemiology*; D012024:Reflex, Oculocardiac; D013285:Strabismus / Q000601:surgery*; D014839:Vomiting / Q000453:epidemiology*
D001285:Atropine