Sana Abbas, Omar Zafar, Muhammad Awais, Beenish Abbas, Umer Hayat, Basit Mehmood.
Efficacy of topical anaesthesia in reduction of oculocardiac reflex during squint surgery.
Pak Armed Forces Med J Jan ;70(3):855-61.

Objective: To determine the efficacy of Topical Anaesthesiain reduction of oculocardiac reflex incidence and severity in patients undergoing squint surgery under general anaesthesia. Study Design: Quasi-Experimental Study. Place and Duration of Study: Armed Forces Institute of Ophthalmology from Nov 2019 to Mar 2020. \ Methodology: Two sixty-six patients (n=266) enrolled in the study, equally divided into two groups i.e. group A –Topical Anaesthetic 0.5% eye drops (n=133) and Group B–Placebo Eye Drops (n=133). Meticulous Pre anaesthesia assessment, Preoperative preparation and written consent ensured, followed by elective squint surgery under general anaesthesia with standard protocols. Results: Two sixty-six patients were enrolled in the study with a mean age of 16.22 ± 4.75 years and there were 122 (45.9%) males and 144 (54.1%) females in the study group. At 10, 20 and 30 minutes after the start of the surgery, the heart rate was significantly lower in the placebo group B as compared to group A (73.14 ± 12.9 vs 85.14 ± 17.5, p<0.001, 73.98 ± 7.7 vs 86.51 ± 25.3, p<0.001, and 74.65 ± 7.0 vs 86.14 ± 22.7, p<0.001) respectively. Similarly, the incidence of Oculocardiac reflex was significantly lower in group A, as compared to placebo group B (20.3% vs 43.6%, p<0.001) and significantly lesser number of patients in group A required administration of atropine during the surgery as compared to group B [2 (1.5%) vs 42 (31.6%), p<0.001]. Conclusion: Instillation of Topical Anestheticin squint surgery under general anaesthesia reduce the intensity and severity of oculocardiac reflex. Therefore, alleviating requirement of anticholinergics administration.

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