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The oculorespiratory reflex revisited.

V F Blanc1, J L Jacob, J Milot

  • 1Department of Anaesthesia, Hôpital Sainte-Justine, Montréal, Québec.

Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie
|September 1, 1988
PubMed
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The oculorespiratory reflex (ORR) consistently occurred during strabismus surgery in children, causing respiratory changes. Controlled ventilation is recommended to prevent potential complications like hypercapnia and hypoxemia.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Respiratory Physiology

Background:

  • The oculorespiratory reflex (ORR) is a known physiological response.
  • Strabismus surgery involves eye muscle manipulation, a potential trigger for ORR.
  • Monitoring respiratory parameters is crucial during pediatric anesthesia.

Purpose of the Study:

  • To investigate the incidence and characteristics of the oculorespiratory reflex (ORR) during strabismus surgery in children.
  • To assess the impact of ORR on respiratory parameters.
  • To evaluate the effectiveness of atropine in modulating the ORR.

Main Methods:

  • Continuous monitoring of intratracheal pressure and capnography in eight children (5-14 years) undergoing strabismus surgery.
  • Evoking the ORR through traction on extrinsic eye muscles.

Related Experiment Videos

  • Administering intravenous atropine to assess its effect on ORR incidence.

    • Main Results:

    • The oculorespiratory reflex (ORR) was observed in 100% of patients, manifesting as slowed or shallow breathing.
    • One patient experienced a 20-second apneic episode requiring manual ventilation.
    • Atropine reduced the incidence of oculocardiac reflex (OCR) but not the ORR.

    Conclusions:

    • Oculorespiratory reflex (ORR) is a consistent finding during strabismus surgery in children.
    • ORR can lead to respiratory compromise, including hypercapnia and hypoxemia.
    • Controlled ventilation is recommended during eye muscle traction in strabismus surgery to mitigate risks.