title: Ketamine or atropine: which one better prevents oculocardiac reflex during eye surgery? A prospective randomized clinical trial.
abstract: Profound bradycardia during eye surgery is a potentially serious event. In clinical practice oculo-cardiac reflex (OCR) is most often encountered during squint surgery. The objective of this study was to assess the occurrence of OCR and prove the effect of ketamine as an induction drug and anticholinergic premedication (atropine) to prevent OCR. This study comprised 90 patients (aged 4-10 years) operated for squint surgery under general anesthesia. Patients were divided into three groups. Using block randomization, each patient enrolled in one of the three groups based on organized random table prepared by statistician. Group K received ketamine as an induction drug, Group A was premedicated with intravenous injection of atropine and Group C did not receive any premedication. Patients were monitored during operation for any bradycardia or dysrhythmias. The observed data showed occurrence of 63% OCR in Group C as compared to 43% in group A and only 20% in Group K. Current study showed that induction with ketamine in the patients of squint surgery under general anesthesia definitely obtunds OCR and prevents any untoward effects of dysrhythmias during eye surgery.
authors: Department of Anesthesiology, Bahrami Hospital, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Anesthesiology, Farabi Hospital, Tehran University of Medical Sciences, Tehran, Iran. eespahbodi@yahoo.com.
authors: Ebrahim
authors: E
authors: Espahbodi
authors: Department of Anesthesiology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Anesthesiology, Farabi Hospital, Tehran University of Medical Sciences, Tehran, Iran. mehdi.sanatkar@gmail.com.
authors: Mehdi
authors: M
authors: Sanatkar
authors: Department of Anesthesiology, Farabi Hospital, Tehran University of Medical Sciences, Tehran, Iran. eespahbodi@yahoo.com.
authors: Hossein
authors: H
authors: Sadrossadat
authors: Department of Anesthesiology, Bahrami Hospital, Tehran University of Medical Sciences, Tehran, Iran. eespahbodi@yahoo.com.
authors: Mohammad Esmaeel
authors: ME
authors: Darabi Vafsi
authors: Department of Anesthesiology, Bahrami Hospital, Tehran University of Medical Sciences, Tehran, Iran. eespahbodi@yahoo.com.
authors: Mitra
authors: M
authors: Azarshahin
authors: Department of Anesthesiology, Farabi Hospital, Tehran University of Medical Sciences, Tehran, Iran. eespahbodi@yahoo.com.
authors: Mehrdad
authors: M
authors: Shoroughi
mesh_terms: D000768:Anesthesia, General / Q000379:methods; D001145:Arrhythmias, Cardiac / Q000453:epidemiology; D001285:Atropine / Q000494:pharmacology / Q000627:therapeutic use*; D001919:Bradycardia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007649:Ketamine / Q000494:pharmacology / Q000627:therapeutic use*; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D011446:Prospective Studies; D012024:Reflex, Oculocardiac / Q000187:drug effects*
chemical_list: D007649:Ketamine; D001285:Atropine