title: The effect of anesthesia depth on the oculocardiac reflex in strabismus surgery.
abstract: The aim of this study was to investigate the effect of the bispectral index (BIS) guided depth of anesthesia to inhibition of the oculocardiac reflex (OCR) during pediatric strabismus surgery. Patients between the ages of 3 and 16 years who were scheduled for elective strabismus surgery were randomly assigned to two groups. In Group 1 (n: 32), the BIS values of the patients were maintained at <50; in Group 2 (n: 28), the BIS values of the patients were maintained at levels greater than or equal to 50 with 4-7 % desflurane in a 50 % O2-air mixture by titrating the concentration during the surgery. The heart rates, presence of dysrhythmia, anticholinergic drug usage and the type of the operated extra ocular muscle were recorded. The incidence of OCR was 25 % in Groups 1 and 64.3 % in Group 2, (p < 0.05). Moreover, the incidence of OCR in group 2 was higher in medial rectus (MR) traction (78.9 %) than in lateral rectus (LR) traction (33.3 %) (p = 0.035), with no significant difference in Group 1 between MR (21.1 %) and LR (26.7 %) tractions (p = 0.83). We found that the lower BIS values are associated with the lower incidence of OCR in pediatric patients undergoing strabismus surgery. And our findings confirmed that the deeper anesthesia has a protective effect against the OCR.
authors.affiliation: Department of Anesthesiology and Reanimation, Gaziosmanpasa University School of Medicine, 60100, Tokat, Turkey. drtugbaguler@hotmail.com.
authors.forename: Tugba
authors.initials: T
authors.lastname: Karaman
authors.affiliation: Department of Ophthalmology, Gaziosmanpasa University School of Medicine, Tokat, Turkey.
authors.forename: Selim
authors.initials: S
authors.lastname: Demir
authors.affiliation: Department of Anesthesiology and Reanimation, Gaziosmanpasa University School of Medicine, 60100, Tokat, Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Dogru
authors.affiliation: Department of Anesthesiology and Reanimation, Gaziosmanpasa University School of Medicine, 60100, Tokat, Turkey.
authors.forename: Aynur
authors.initials: A
authors.lastname: Şahin
authors.affiliation: Department of Anesthesiology and Reanimation, Gaziosmanpasa University School of Medicine, 60100, Tokat, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Tapar
authors.affiliation: Department of Anesthesiology and Reanimation, Gaziosmanpasa University School of Medicine, 60100, Tokat, Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Karaman
authors.affiliation: Department of Anesthesiology and Reanimation, Gaziosmanpasa University School of Medicine, 60100, Tokat, Turkey.
authors.forename: Ziya
authors.initials: Z
authors.lastname: Kaya
authors.affiliation: Department of Anesthesiology and Reanimation, Gaziosmanpasa University School of Medicine, 60100, Tokat, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Suren
authors.affiliation: Department of Anesthesiology and Reanimation, Gaziosmanpasa University School of Medicine, 60100, Tokat, Turkey.
authors.forename: Semih
authors.initials: S
authors.lastname: Arici
mesh_terms: D000293:Adolescent; D000758:Anesthesia / Q000379:methods*; D000777:Anesthetics / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003243:Consciousness; D000077335:Desflurane; D005260:Female; D006339:Heart Rate; D006801:Humans; D015994:Incidence; D007530:Isoflurane / Q000031:analogs & derivatives / Q000627:therapeutic use; D008297:Male; D008738:Methyl Ethers / Q000627:therapeutic use; D016343:Monitoring, Intraoperative / Q000379:methods; D009801:Oculomotor Muscles / Q000502:physiology; D010372:Pediatrics / Q000379:methods; D012024:Reflex, Oculocardiac; D000077149:Sevoflurane; D013285:Strabismus / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D000777:Anesthetics; D008738:Methyl Ethers; D000077149:Sevoflurane; D000077335:Desflurane; D007530:Isoflurane
keywords: Anesthesia; Consciousness monitors; General; Pediatrics; Strabismus