Association of oculocardiac reflex and postoperative nausea and vomiting in strabismus surgery in children anesthetized with halothane and nitrous oxide
Identifieur interne : 001182 ( Main/Exploration ); précédent : 001181; suivant : 001183Association of oculocardiac reflex and postoperative nausea and vomiting in strabismus surgery in children anesthetized with halothane and nitrous oxide
Auteurs : Nenad Karanovic [Croatie] ; Mladen Carev [Croatie] ; Ante Ujevic [Croatie] ; Goran Kardum [Croatie] ; Zoran Dogas [Croatie]Source :
- Paediatric anaesthesia : (Paris) [ 1155-5645 ] ; 2006.
Descripteurs français
- Pascal (Inist)
- Wicri :
English descriptors
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Abstract
Background: Postoperative nausea and vomiting (PONV) occurs frequently after strabismus surgery. The controversy still exists regarding the association of PONV and the oculocardiac reflex (OCR). A recent study has proven that rocuronium attenuates OCR. If these two occurrences are dependent, it is expected that with the diminution of OCR, occurrence of PONV will also be reduced. The goal of this randomized, controlled study was to prove an association between OCR and PONV by attenuating OCR with 0.4 mg.kg-1 of rocuronium and subsequently diminishing PONV if these occurrences are associated. Methods: A total of 119 ASA 1 children, aged between 3 and 10, undergoing surgery of the medial rectus muscle, were randomly assigned to two groups. In group R (n = 59), 0.4 mg.kg-1 of rocuronium was administered i.v. before intubation. Group C (controls, n = 60) received no muscle relaxant. The anesthesia was induced and maintained with halothane and N2O/O2 (50/50%). Chi-squared test, Fisher's exact test, t-test, and ANOVA were used for statistical analysis; P-value <0.05 was considered statistically significant. Results: There were no differences between groups regarding patients' characteristics as well as endtidal halothane and duration of surgery and anesthesia. The occurrence of OCR was different between groups (R: 16/59, 27.1%, C: 28/60, 46.7%; P = 0.027), but not the occurrence of PONV (R: 27/59, 45.8%, C: 28/60, 46.7%; P = 0.921). There was an equal number of patients with PONV and bradycardias in both groups (R: 4/27 vs C: 4/28; P = 0.858), whereas there was different, but statistically insignificant distribution of patients (R: 3/27 vs C: 10/28; P = 0.086) with PONV and arrhythmias other than bradycardia. However, simultaneous occurrence of total OCR and PONV in the 24-h period was not different between the two groups (P = 0.964). Conclusions: Rocuronium (0.4 mg.kg-1) attenuates the occurrence of OCR, but with the reduced occurrence of OCR we were not able to attenuate the occurrence of PONV, therefore the association of OCR and PONV in strabismus surgery in children anesthetized with halothane and nitrous oxide remains unclear, and if there is a link between the two, it could be related to arrhythmias and not bradycardia.
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Split</s1><s3>HRV</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>Croatie</country><wicri:noRegion>Department of Anesthesiology and Intensive Care, University Hospital Split</wicri:noRegion></affiliation></author><author><name sortKey="Ujevic, Ante" sort="Ujevic, Ante" uniqKey="Ujevic A" first="Ante" last="Ujevic">Ante Ujevic</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Anesthesiology and Intensive Care, University Hospital Split</s1><s3>HRV</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>Croatie</country><wicri:noRegion>Department of Anesthesiology and Intensive Care, University Hospital Split</wicri:noRegion></affiliation></author><author><name sortKey="Kardum, Goran" sort="Kardum, Goran" uniqKey="Kardum G" first="Goran" last="Kardum">Goran Kardum</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Neuroscience and Scientific Methodology, University of Split School of Medicine, Soltanska, 2</s1><s2>Split</s2><s3>HRV</s3><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Croatie</country><wicri:noRegion>Split</wicri:noRegion></affiliation></author><author><name sortKey="Dogas, Zoran" sort="Dogas, Zoran" uniqKey="Dogas Z" first="Zoran" last="Dogas">Zoran Dogas</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Neuroscience and Scientific Methodology, University of Split School of Medicine, Soltanska, 2</s1><s2>Split</s2><s3>HRV</s3><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Croatie</country><wicri:noRegion>Split</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">06-0406015</idno><date when="2006">2006</date><idno type="stanalyst">PASCAL 06-0406015 INIST</idno><idno type="RBID">Pascal:06-0406015</idno><idno type="wicri:Area/PascalFrancis/Corpus">000375</idno><idno type="wicri:Area/PascalFrancis/Curation">000411</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000352</idno><idno type="wicri:doubleKey">1155-5645:2006:Karanovic N:association:of:oculocardiac</idno><idno type="wicri:Area/Main/Merge">001213</idno><idno type="wicri:Area/Main/Curation">001182</idno><idno type="wicri:Area/Main/Exploration">001182</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Association of oculocardiac reflex and postoperative nausea and vomiting in strabismus surgery in children anesthetized with halothane and nitrous oxide</title><author><name sortKey="Karanovic, Nenad" sort="Karanovic, Nenad" uniqKey="Karanovic N" first="Nenad" last="Karanovic">Nenad Karanovic</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Anesthesiology and Intensive Care, University Hospital Split</s1><s3>HRV</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>Croatie</country><wicri:noRegion>Department of Anesthesiology and Intensive Care, University Hospital Split</wicri:noRegion></affiliation></author><author><name sortKey="Carev, Mladen" sort="Carev, Mladen" uniqKey="Carev M" first="Mladen" last="Carev">Mladen Carev</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Anesthesiology and Intensive Care, University Hospital Split</s1><s3>HRV</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>Croatie</country><wicri:noRegion>Department of Anesthesiology and Intensive Care, University Hospital Split</wicri:noRegion></affiliation></author><author><name sortKey="Ujevic, Ante" sort="Ujevic, Ante" uniqKey="Ujevic A" first="Ante" last="Ujevic">Ante Ujevic</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Anesthesiology and Intensive Care, University Hospital Split</s1><s3>HRV</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>Croatie</country><wicri:noRegion>Department of Anesthesiology and Intensive Care, University Hospital Split</wicri:noRegion></affiliation></author><author><name sortKey="Kardum, Goran" sort="Kardum, Goran" uniqKey="Kardum G" first="Goran" last="Kardum">Goran Kardum</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Neuroscience and Scientific Methodology, University of Split School of Medicine, Soltanska, 2</s1><s2>Split</s2><s3>HRV</s3><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Croatie</country><wicri:noRegion>Split</wicri:noRegion></affiliation></author><author><name sortKey="Dogas, Zoran" sort="Dogas, Zoran" uniqKey="Dogas Z" first="Zoran" last="Dogas">Zoran Dogas</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Neuroscience and Scientific Methodology, University of Split School of Medicine, Soltanska, 2</s1><s2>Split</s2><s3>HRV</s3><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Croatie</country><wicri:noRegion>Split</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Paediatric anaesthesia : (Paris)</title><title level="j" type="abbreviated">Paediatr. anaesth. : (Paris)</title><idno type="ISSN">1155-5645</idno><imprint><date when="2006">2006</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Paediatric anaesthesia : (Paris)</title><title level="j" type="abbreviated">Paediatr. anaesth. : (Paris)</title><idno type="ISSN">1155-5645</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Anesthesia</term><term>Child</term><term>General anesthetic</term><term>Halothane</term><term>Nausea</term><term>Postoperative</term><term>Strabismus</term><term>Surgery</term><term>Vomiting</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Strabisme</term><term>Postopératoire</term><term>Nausée</term><term>Vomissement</term><term>Chirurgie</term><term>Enfant</term><term>Halothane</term><term>Anesthésie</term><term>Anesthésique général</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Chirurgie</term><term>Enfant</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background: Postoperative nausea and vomiting (PONV) occurs frequently after strabismus surgery. The controversy still exists regarding the association of PONV and the oculocardiac reflex (OCR). A recent study has proven that rocuronium attenuates OCR. If these two occurrences are dependent, it is expected that with the diminution of OCR, occurrence of PONV will also be reduced. The goal of this randomized, controlled study was to prove an association between OCR and PONV by attenuating OCR with 0.4 mg.kg<sup>-1</sup> of rocuronium and subsequently diminishing PONV if these occurrences are associated. Methods: A total of 119 ASA 1 children, aged between 3 and 10, undergoing surgery of the medial rectus muscle, were randomly assigned to two groups. In group R (n = 59), 0.4 mg.kg<sup>-1</sup> of rocuronium was administered i.v. before intubation. Group C (controls, n = 60) received no muscle relaxant. The anesthesia was induced and maintained with halothane and N<sub>2</sub>O/O<sub>2</sub> (50/50%). Chi-squared test, Fisher's exact test, t-test, and ANOVA were used for statistical analysis; P-value <0.05 was considered statistically significant. Results: There were no differences between groups regarding patients' characteristics as well as endtidal halothane and duration of surgery and anesthesia. The occurrence of OCR was different between groups (R: 16/59, 27.1%, C: 28/60, 46.7%; P = 0.027), but not the occurrence of PONV (R: 27/59, 45.8%, C: 28/60, 46.7%; P = 0.921). There was an equal number of patients with PONV and bradycardias in both groups (R: 4/27 vs C: 4/28; P = 0.858), whereas there was different, but statistically insignificant distribution of patients (R: 3/27 vs C: 10/28; P = 0.086) with PONV and arrhythmias other than bradycardia. However, simultaneous occurrence of total OCR and PONV in the 24-h period was not different between the two groups (P = 0.964). Conclusions: Rocuronium (0.4 mg.kg<sup>-1</sup>) attenuates the occurrence of OCR, but with the reduced occurrence of OCR we were not able to attenuate the occurrence of PONV, therefore the association of OCR and PONV in strabismus surgery in children anesthetized with halothane and nitrous oxide remains unclear, and if there is a link between the two, it could be related to arrhythmias and not bradycardia.</div></front></TEI><affiliations><list><country><li>Croatie</li></country></list><tree><country name="Croatie"><noRegion><name sortKey="Karanovic, Nenad" sort="Karanovic, Nenad" uniqKey="Karanovic N" first="Nenad" last="Karanovic">Nenad Karanovic</name></noRegion><name sortKey="Carev, Mladen" sort="Carev, Mladen" uniqKey="Carev M" first="Mladen" last="Carev">Mladen Carev</name><name sortKey="Dogas, Zoran" sort="Dogas, Zoran" uniqKey="Dogas Z" first="Zoran" last="Dogas">Zoran Dogas</name><name sortKey="Kardum, Goran" sort="Kardum, Goran" uniqKey="Kardum G" first="Goran" last="Kardum">Goran Kardum</name><name sortKey="Ujevic, Ante" sort="Ujevic, Ante" uniqKey="Ujevic A" first="Ante" last="Ujevic">Ante Ujevic</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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