J Korean Ophthalmol Soc.  2008 Jan;49(1):1-7. 10.3341/jkos.2008.49.1.1.

Oculocardiac Reflex during Ptosis Operation under Local Anesthesia

• Kang HG
• Kim KH

• KMID: 2211175
• DOI: http://doi.org/10.3341/jkos.2008.49.1.1

Abstract

PURPOSE: To evaluate the incidence and examine the development of oculocardiac reflex during ptosis operation under local anesthesia.
METHODS
Twenty-eight patients (52 eyes) who underwent ptosis operation under local anesthesia participated in this prospective study. We examined the change of heart rate. We also investigated the incidence of oculocardiac reflex and analyzed factors associated with it.
RESULTS
The mean preoperative heart rate was 76.06+/-11.24 beats/min. During local anesthetic injection, skin incision, traction of the central fat pad, traction of the medial fat pad, traction of the levator palpebrae muscle, the mean heart rates were 74.81+/-12.64 beats/min, 74.73+/-12.20 beats/min, 73.63+/-11.73 beats/min, 73.35+/-12.24 beats/min, 71.44+/-11.93 beats/min respectively. Hence, the mean heart rate decreased during each successive part of the operation. The oculocardiac reflex was positive in 24 (46.2%) of 52 eyes. There was no significant difference between the incidence of oculocardiac reflex in males and females. The incidence of oculocardiac reflex was highest during traction of the levator palpebrae muscle.
CONCLUSIONS
During ptosis operation under local anesthesia, oculocardiac reflex can occur. Gentle manipulation of surgical tissues and cardiac monitoring is needed to prevent side effects from oculocardiac reflex.

Keyword

Blepharoplasty; Oculocardicac reflex; Ptosis operation

MeSH Terms

Adipose Tissue
Anesthesia, Local
Blepharoplasty
Eye
Female
Heart Rate
Humans
Incidence
Male
Muscles
Prospective Studies
Reflex, Oculocardiac
Skin
Traction

Figure

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  Figure 1. Incidence of oculocardiac reflex according to surgical procedures. 1, local anesthetics injection; 2, skin incision; 3, central fat pad traction; 4, medial fat pad traction; 5, levator palpebrae muscle traction.

Reference

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