demonstrated that the trigeminal depressor response is the result of the combined excitation of cardiovagal nerves and inhibition of cardiac sympathetic nerves. The reflex reaction results from combined excitation of cardiovagal and inhibition of cardiac sympathetic nerves. OCR does not occur in every patient, so it may be beneficial to identify a predisposition in the individual patients. It is a trigeminocardiac reflex, also called Aschner’s reflex.
The reflex that is most often encountered during ophthalmologic procedures is the oculocardiac reflex (OCR), resulting mainly, but not only, in sinus bradycardia. The release of traction was generally sufficient to treat the onset of cardiac deceleration. In seven cases, the decision was taken to terminate the operation prematurely due to prolonged cardiac rhythm disturbances. According to one of the first analyses on this subject, which included 219 patients who underwent surgery for squint, cataract, iridectomy, and enucleation under general anaesthesia and an additional 15 patients who underwent surgery for cataract under local anaesthesia, isolated extrasystoles were common, particularly in older patients, and sustained ectopic cardiac arrhythmias were observed in 46% of patients of all ages. Surgery can result in a severe slowing of the heart rate and, in some cases, cardiac arrest. However, in many cases, eye surgeries require general anaesthesia, which is associated with a number of potential complications as well as with situations in which adverse cardiovascular symptoms may occur due to the surgical technique. patients in two 5-year periods, respectively there were no intraoperative deaths, and the few deaths which did occur all occurred within 1 and 18 days postoperatively. Data on fatal complications and unfavourable outcomes among patients undergoing eye surgery are scarce and not very recent.
To rate ocr for mac trial#
Trial registrationĬ identifier no.: NCT01714362Įye surgery, which is relatively less invasive than other types of surgical procedures, is considered safe in terms of its influence on a patient’s general condition. The prediction of OCR based on initial ANS tone was not possible, and the initial heart rate, blood pressure, age, sex, and ASA status were not helpful for the identification of patients at risk of this reflex. There was no relationship between the incidence of the OCR and the analysed parameters. No difference was found in the analysed parameters between patients with and without oculocardiac reflex. Oculocardiac reflex was observed in 32 patients (76.2%). Resultsĭata from 42 patients were analysed. The statistical analysis also included patient age, sex, ASA status and preanaesthesia and premanoeuvre heart rate and blood pressure. Based on that, frequency domain HRV parameters from 5-min Holter electrocardiogram recordings before anaesthesia induction and before eyeball traction were used for the analysis. Thus, the LF/HF ratio reflects the actual balance between sympathetic and parasympathetic activity. However, in practice, LF changes can be considered to reflect sympathetic changes. High-frequency (HF) changes in HRV are thought to reflect parasympathetic impulse transmission, whereas low-frequency (LF) changes reflect both sympathetic and parasympathetic activity. All patients had underwent episcleral buckling under general anaesthesia. Methodsįifty-two adults of both sexes (age range 18–65 years) with American Society of Anesthesiologists (ASA) physical status class 1 and 2 were enrolled in this study. The aim of this study was to determine whether it is possible to predict the occurrence of oculocardiac reflex (OCR) based on heart rate variability (HRV) analysis for autonomic nervous system (ANS) activity assessment measured prior to the induction of anaesthesia and immediately before eyeball traction. In addition, adverse cardiovascular symptoms, such as severe slowing of the heart rate and, in some cases, cardiac arrest may occur due to the surgical technique. Ophthalmic surgery is assumed to be safe, but some operations require general anaesthesia which is associated with a number of potential complications.
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