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Hydroxyzine Dihydrochloride Premedication Is a Necessity for Pediatric Patients Undergoing Strabismus Surgery: An

Fatma Ferda Kartufan1, Nurcan Kizilcik2, Sule Ziylan3

  • 1Department of Anesthesia and Reanimation, Hospital of Medistanbul, Istanbul, Turkey.

Journal of Ophthalmology
|October 3, 2022
PubMed

Insights

Hydroxyzine combined with midazolam significantly reduced the incidence of oculocardiac reflex (OCR) during surgery compared to midazolam alone. This finding highlights a potential improvement in patient safety by mitigating OCR events.

Area of Science:

  • Anesthesiology
  • Pharmacology

Background:

  • The oculocardiac reflex (OCR) is a common complication during ophthalmic surgery.
  • Premedication strategies aim to mitigate adverse events like OCR.

Purpose of the Study:

  • To compare the efficacy of hydroxyzine plus midazolam versus midazolam alone in reducing the incidence of OCR.
  • To evaluate the impact of different hydroxyzine dosages on OCR incidence.

Main Methods:

  • A single-blind, observational prospective clinical trial involving 45 patients divided into three groups.
  • Groups received midazolam alone, or hydroxyzine plus midazolam at varying doses.
  • OCR incidence, heart rate changes, and sedation levels were recorded and compared.

Main Results:

  • Hydroxyzine combined with midazolam significantly decreased OCR incidence compared to midazolam alone (p=0.004).
  • Heart rates (HR) showed significant increases post-induction and pre/post-retraction in groups receiving hydroxyzine (p=0.002, p<0.001).
  • The rectus medialis muscle was most frequently associated with OCR.

Conclusions:

  • Premedication with hydroxyzine (0.5 or 1 mg) and midazolam (0.5 mg) effectively reduces OCR incidence.
  • Combination therapy offers a potential advantage over midazolam monotherapy for managing OCR in surgical settings.
Abstract

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