title: Adjustment in patients with asystole during strabismus surgery.
abstract: OBJECTIVE
  To investigate whether patients who developed asystole during strabismus surgery under general anesthesia also develop asystole during adjustment, and whether adjustment can safely be performed under topical anesthesia in these patients.
  
  
  METHODS
  Retrospective, noncomparative interventional case series.
  
  
  METHODS
  Adjustment was performed with topical anesthesia in four patients aged 28, 32, 50, and 53 years who exhibited asystole during strabismus surgery under general anesthesia. Blood pressure and electrocardiogram were monitored during the adjustment.
  
  
  RESULTS
  Adjustment was successfully completed in all patients without asystole. Two patients showed oculocardiac reflex (OCR), with a reduction in heart rate (HR) >20% of the baseline value. One of these patients exhibited severe OCR that developed when the patient's posture was changed from the supine to the sitting position for measurement of the angle of strabismus after adjustment, and again during conjunctival manipulation after conjunctival closure. No patient required atropine.
  
  
  CONCLUSIONS
  Adjustment can safely be performed under topical anesthesia in patients who developed asystole during strabismus surgery under general anesthesia.
authors.affiliation: Department of Anesthesiology, Seoul National University College of Medicine, Seoul National University Boramae Medical Center, Seoul, South Korea.
authors.forename: Seong-Won
authors.initials: SW
authors.lastname: Min
authors.forename: Jeong-Min
authors.initials: JM
authors.lastname: Hwang
mesh_terms: D000328:Adult; D000768:Anesthesia, General; D000772:Anesthesia, Local; D001794:Blood Pressure / Q000502:physiology; D004562:Electrocardiography; D005260:Female; D006323:Heart Arrest / Q000503:physiopathology*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009801:Oculomotor Muscles / Q000503:physiopathology / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures; D012024:Reflex, Oculocardiac / Q000502:physiology; D012086:Reoperation; D012189:Retrospective Studies; D013285:Strabismus / Q000503:physiopathology / Q000601:surgery*; D013599:Systole; D014630:Vagus Nerve / Q000502:physiology