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Oculocardiac reflex during retinal surgery using peribulbar block and nitrous narcotic anesthesia
V K Grover1, N Bhardwaj, N Shobana
1Department of Anaesthesia, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Ophthalmic Surgery and Lasers
|April 21, 1998
Summary
Local anesthesia is safer for retinal detachment surgery than general anesthesia, significantly reducing the oculocardiac reflex (OCR) and arrhythmias. This finding aids in selecting the best anesthetic approach for extraocular muscle traction procedures.
Area of Science:
- Ophthalmology
- Anesthesiology
- Cardiology
Background:
- The oculocardiac reflex (OCR) is a concern during surgeries involving extraocular muscle manipulation.
- Understanding anesthesia's impact on OCR is crucial for patient safety.
Purpose of the Study:
- To compare the effects of local versus general anesthesia on OCR during retinal detachment surgery.
- To identify the safest anesthesia type and which extraocular muscles elicit a higher OCR incidence.
Main Methods:
- 30 patients (ASA-I, 40-60 years) undergoing retinal detachment surgery were studied.
- 15 received general anesthesia, 15 received local peribulbar block.
- 400g traction applied to extraocular muscles; heart rate, rhythm, and ECG monitored.
Main Results:
- OCR incidence was 63.3% with general anesthesia vs. 14.4% with local anesthesia.
- General anesthesia caused significant heart rate decrease with rectus and oblique muscle traction.
- Dysrhythmia incidence was 20% with general anesthesia, 6.67% with local anesthesia.
Conclusions:
- Local anesthesia resulted in less bradycardia and fewer ectopic arrhythmias compared to general anesthesia.
- Local anesthesia may be a safer and superior choice for surgeries requiring extraocular muscle traction.