Subject(s)
Anesthesia, General , Ophthalmologic Surgical Procedures , Reflex, Oculocardiac , Reflex , Age Factors , Arrhythmias, Cardiac/etiology , Atropine/therapeutic use , Butylscopolammonium Bromide/therapeutic use , Ciliary Body/innervation , Gallamine Triethiodide/therapeutic use , Glycopyrrolate/therapeutic use , Heart Arrest/etiology , Humans , Nerve Block , Pancuronium/therapeutic use , Strabismus/surgery , Trigeminal Nerve/physiology , Vagus Nerve/physiologyABSTRACT
The authors compare the effect of two muscle relaxants, atracurium and pancuronium, on the bradycardia resulting from the oculocardiac reflex during eye surgery for strabismus in children. Two groups, each composed of 15 children, received either pancuronium or atracurium during strabismus operations. Heart rate and rhythm were observed at several points during the operations, and the changes that occurred in the two groups were compared. We found that the incidence and severity of the bradycardia, the incidence of dysrhythmias, and the need for atropine administration were significantly greater in the atracurium group than in the pancuronium group.
Subject(s)
Atracurium/pharmacology , Pancuronium/pharmacology , Reflex, Oculocardiac/drug effects , Child , Child, Preschool , Female , Heart Rate/drug effects , Heart Rate/physiology , Humans , Male , Reflex, Oculocardiac/physiology , Strabismus/surgeryABSTRACT
Prior to strabismus surgery, succinylcholine produces a sustained contraction of the extraocular muscles that interferes with an accurate interpretation of the forced duction test (FDT) for up to 20 minutes. Pancuronium, a nondepolarizing muscle relaxant, does not alter the FDT. Suggestions are given for management of anesthetic induction with or without muscle relaxants to facilitate intubation.
Subject(s)
Anesthesia, Inhalation , Intubation, Intratracheal , Oculomotor Muscles/drug effects , Strabismus/surgery , Succinylcholine/adverse effects , Adolescent , Child , Child, Preschool , Humans , Infant , Muscle Contraction , Pancuronium/pharmacology , Strabismus/diagnosisABSTRACT
Eighty children (aged 2-12 yr) undergoing strabismus surgery were randomly assigned to receive tubocurarine, alcuronium, pancuronium or vecuronium during anaesthesia with thiopentone, fentanyl and nitrous oxide in oxygen. Heart rate and rhythm were recorded before and after the induction of anaesthesia and before and during traction on an extraocular muscle. End-tidal carbon dioxide concentration and the degree of neuromuscular blockade were monitored. Alcuronium seemed to give more protection against the oculocardiac reflex (defined as a 20% decrease in heart rate) than did tubocurarine, pancuronium or vecuronium.