Purpose:

To evaluate the incidence of oculocardiac reflex in different extraocular muscle groups, postoperative nausea and vomiting during desflurane anesthesia for pediatric strabismus surgery.

Methods:

We enrolled 18 patients between 2-6 years old (group 1) and 17 patients between 7-15 years old (group 2, undergoing strabismus surgery with desflurane anesthesia. We evaluated heart rates, systolic blood pressures and peripheral oxygen saturation rates before and after entubation, when we reached the extraocular muscle (EOM) region and during EOM traction. Decrease ≥ 20% from the baseline heart rate, arythmia- arrest occurrence was accepted as oculocardiac reflex (OCR). Also the incidence of postoperative nausea and vomiting (PONV) and antiemetic drug needs was evaluated 24 hours following the surgery by questioning the parents on the next day exam.

Results:

The incidence of OCR was 48% in group 1 and 36.3% in group 2 and the difference was insignificant. There was also no difference in OCR incidence between girls- boys and right- left eyes. OCR occurred in 41 of 96 muscles operated and was most common in medial rectus, followed by inferior rectus, inferior oblique and lateral rectus muscles. The incidence of PONV was 11.4%.

Conclusion:

Desflurane, one of inhalation anesthetics is frequently used today in strabismus surgeries because of its effective induction- fast recovery effects and minimal postoperative complications. The low rates of OCR and PONV makes desflurane a safe and effective agent in pediatric strabismus surgery.

Keywords: Desflurane, oculocardiac reflex, anesthesia, side effects