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KMID : 0356919930260020285
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Korean Journal of Anesthesiology
1993 Volume.26 No. 2 p.285 ~ p.292
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Effects of Vecuronium, Pancuronium, and Succinylcholine on the Oculocardiac Reflex in Children
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Abstract
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Oculocardiac reflex occurs frequently during strabismus surgery in children. The most common arrythmia is bradycardia, with resolution after traction of extrocular muscle is withdrawn. However, the reflex is potentially fatal as it can cause
cardiac
arrest.
This study was undertaken to compare the effect of three muscle relaxants, succinylcholine, pancuronium and vecuronium on the oculocardiac reflex, and to determine which could prevent it during strabismus surgery in children.
We compared the change of heart rate and systolic blood pressure in each muscle relaxant group before and after traction of extraocular muscle in unpremedicated children between 3 to 15 years old with atropine or glycopyrrolate undergoing
strabismus
surgery.
The incidences of oculocardiac reflex were 31.6% in vecuronium group, 14.0% in pancuronium group and 18.4% in succinylcholine group. Overall incidence was 20.1%.
Hesrt rate decreased significantly in vecuronium and succinylcholine group, but systolic blood pressure was anchanged. In pancuronium group, changes in heart rate and systolic blood pressure were not significant.
From the above results, the use of pancuronium which does not decrcase heart rate will bemore protective in preventing the oculocardiac reflex during strabismus surgery in children.
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