Effect of muscle relaxants on short-term results of exotropia surgery: a focus on resection procedures.
OBJECTIVE
We investigated the effect of muscle relaxants (atracurium) on the outcomes of intermittent exotropia surgery under general anesthesia, with a focus on resection procedures.


METHODS
Thirty four patients who underwent recession and resection (R&R) were divided into two groups: atracurium usage (group A, n=18) and no atracurium usage (group B, n=16). Patients were divided into two subgroups according to the amount of resection of the medial rectus (MR): less than 5 mm (group 1, n=13) or 5 mm and greater (group 2, n=21). Deviation angles were compared between groups and subgroups. Surgical outcome was defined as successful if distant deviation angles were equal to or less than 10 prism diopters.


RESULTS
The overall postoperative deviation angles did not show statistically significant differences between groups A and B. However, in patients with larger MR resections (> or = 5 mm), the 1 week postoperative distant deviation was significantly larger in group A (1.8+/-2.6 PD) than in group B (-1.6+/-4.6 PD, p=0.048 by t-test). The overall undercorrection rate at 3 months postoperatively for group A was 16.7%, which was higher than that of group B (6.3%), and the difference was even larger in subgroups with larger MR resections (> or = 5 mm): 18.2% in group A and 0% in group B.


CONCLUSIONS
Patients who underwent R&R procedures under general anesthesia with a muscle relaxant tended to be less corrected than those without muscle relaxant, especially in the early postoperative period and with a larger MR resection equal to or greater than 5 mm. However, there was no significant difference in the later postoperative period.
Chang
Young-Suk
YS
Department of Ophthalmology, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea.
Baek
Seung-Hee
SH
Park
Jeong-Min
JM
Kwon
Hee-Uk
HU
Kim
Yong-Ran
YR
D000769:Anesthesia, Inhalation; D001279:Atracurium / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D005099:Exotropia / Q000503:physiopathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D009126:Muscle Relaxation; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage*; D009801:Oculomotor Muscles / Q000503:physiopathology*; D013508:Ophthalmologic Surgical Procedures; D016896:Treatment Outcome
D003473:Neuromuscular Nondepolarizing Agents; D001279:Atracurium