Anaes SAQs · Ophthalmic anaesthesia
Oculocardiac reflex and intraocular pressure under anaesthesia
Final-examination SAQ for oculocardiac-reflex-iop.
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ANZCAFRCAEDAICABAFCAI
Prompt
Child under GA for strabismus develops HR 40 with muscle traction. Outline mechanism and management. Discuss IOP drug effects briefly.
Model answer
OCR (5). V1 afferent, vagus efferent; stop traction first; atropine in the taught 10-20 microg/kg band per local paediatric protocol.[1]
Prevention (5). Depth, gentle surgery, consider anticholinergic prophylaxis in paeds (profound bradycardia in almost 10% of strabismus cases without it).[1]
IOP (5). Sux/ketamine raise (taught sux rise 5-10 mmHg); propofol/volatiles lower (taught directions); normal range per local ophthalmic reference (taught 10-21 mmHg).[2][3]
References3ShowHide
- [1]Arnold RW The Oculocardiac Reflex: A Review. Clinical Ophthalmology, 2021.PMID 34194223
- [2]Vachon CA, Warner DO, Bacon DR Succinylcholine and the open globe. Tracing the teaching. Anesthesiology, 2003.PMID 12826863
- [3]Pucchio A, Pur DR, Dhawan A, et al. Anesthesia for ophthalmic surgery: an educational review. International Ophthalmology, 2023.PMID 36436168