A case of bradycardia is reported which was precipitated by cold normal saline applied to the eye during general anaesthesia. The history and physiology of the diving reflex is discussed and we believe that these data suggest that this patient's bradycardia was induced by the diving reflex, and not by the oculocardiac reflex.

A case is reported of bradycardia and sinus arrest induced by insertion of a nasal temperature probe. Other possible causes of bradycardia and sinus arrest under anaesthesia are reviewed briefly. Evidence for the neurological basis of a nasocardiac reflex, similar to the oculocardiac reflex, is presented. A minor, trivial stimulus may elicit this reflex.

OBJECTIVE To analyze the effectiveness and usefulness of contact topical anesthesia in strabismus surgery in adult patients. MATERIAL AND METHODS A prospective study was conducted on 20 patients undergoing strabismus surgery using contact topical anesthesia and sedation with remifentanil. The intensity of pain was recorded using a numeric pain rating scale at the time of anesthesia implementa...

Healthy teens and adults performed four vagotonic maneuvers. A large series of strabismus surgery patients had deliberately quantified tension on extraocular rectus muscles during general anesthesia. The mean bradycardia was greatest for diving response (apneic facial exposure to cold) and Valsalva maneuver and least for pressure on the globe and carotid sinus massage. Bradycardia occurred for ...

The oculocardiac reflex was quantitatively studied in 15 patients with strabismus. The reflex was observed in all patients when the medial rectus and inferior oblique muscles were stretched; the medial rectus muscle had a lower threshold than the inferior oblique. Bradycardia was evoked in 7 of the 15 patients when the lateral rectus was tractioned with tensions of 50 g and 600 g. The oculocard...

Background: OCR commonly occurs during strabismus surgery, producing bradycardia, arrhythmias and even cardiac arrest after manipulation of orbital structures. Ketamine is NMDA receptor antagonist acts as an analgesic. Aim: To determine the effect ketamine premedication on prevention surgery. Study design: Randomized control trial Methodology: 60 patients were randomly divided into two groups i...