Asystole due to the oculocardiac reflex during strabismus surgery: a report of two cases

The oculocardiac reflex is a well-known entity which may result in vagal depression of the heart when pressure is placed on the eyeball or when traction is applied to the extraocular muscles. Bradycardia is, by far, the most common cardiac response to these stimuli. We report two cases of ten-second episodes of asystole during traction on the medial rectus muscle as a reminder to ophthalmologists and anesthesiologists alike that this complication can and does occur during strabismus surgery.