Prevention of the Oculo-Cardiac Reflex in Children Comparison of Retrobulbar Block and Intravenous Atropine

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Abstract
An investigation was conducted comparing methods recommended to prevent the oculocardiac reflex in children during operation for strabismus. In 58% of operations preanesthetic medication with atropine offered no protection for correction of unilateral strabismus. Intravenous injection of atropine, 0.0025 mg/pound, provided some protection, reducing the incidence to 28%. Retrobulbar block with lidocaine prevented the reflex in all instances. These differences are statistically significant. It is concluded that retrobulbar block is an effective method of preventing the oculocardiac reflex, and superior to the intravenous injection of atropine in the doses which were recommended.

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