Korean J Anesthesiol.  1993 Apr;26(2):285-292. 10.4097/kjae.1993.26.2.285.

Effects of Vecuronium, Pancuronium, and Succinylcholine on the Oculocardiac Reflex in Children

• Lee YS
• Kang H
• Kim SD
• Kim KW

• KMID: 2239256
• DOI: http://doi.org/10.4097/kjae.1993.26.2.285

Abstract

Oculocardiac reflex occurs frequently during strabismus surgery in children. The most common arrythmia is bradycardia, with resolution after traction of extraocular muscle is withdrawn.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%. Heart rate decreased significantly in vecuronium and succinylcholine group, but systolic blood pressure was unchanged. 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 decrease heart rate will be more protective in preventing the oculecardiac reflex during strabismus surgery in children.

Keyword

Oculocardiac reflex; Strabismus surgery; Muscle relaxant; Extraocular muscle

MeSH Terms

Adolescent
Arrhythmias, Cardiac
Atropine
Blood Pressure
Bradycardia
Child*
Glycopyrrolate
Heart Arrest
Heart Rate
Humans
Incidence
Pancuronium*
Reflex
Reflex, Oculocardiac*
Strabismus
Succinylcholine*
Traction
Vecuronium Bromide*
Atropine
Glycopyrrolate
Pancuronium
Succinylcholine
Vecuronium Bromide