Midazolam i̇le sevofluranin okulokardiyak refleks üzerine etkilerinin karşilaştirilmasi

We aimed to investigate the effects of midazolam and sevoflurane on oculocardiac reflex (OCR), which is a major problem in strabismus surgery. After taking the Hospital Ethics Committee approval and informed consent from the parents, 40 ASA I patients, 1-7 years old, scheduled for elective unilateral strabismus surgery were included in the study. All patients were given atropine and midazolam perorally for premedication. Patients were randomly allocated into two groups; Group S, was given sevoflurane, Group M was given midazolam. In Group S, anesthesia was induced with by sevoflurane 8 % in O₂ 40 % and N₂O 60 %, via face mask and sevoflurane was reduced to 2 % for maintenance. Whereas in Group M, anaesthesia was induced with 0.5-1 mg kg ^-1 and maintained with midazolam at an infusion rate of 4 μgr kg min^-1 supplemented by O₂ 40 %, N₂O 60 %. Tracheal intubation was facilitated by administration of veeuronium 0.1 mg kg^-1. Heart rate, systolic blood pressure, endtidal CO₂, OCR, arrhytmias and number of muscles being operated were recorded during the operation. Postoperative nausea and vomiting were also recorded. Both groups were similar with respect to number of operated muscles, endtidal CO₂ values. The incidence of OCR was lower in Group S, which was a statistically significant finding (p<0.001). The incidence of nausea and vomiting were low in both groups. It may concluded that, sevoflurane decreases the incidence of OCR and may be a suitable agent for strabismus surgery when supplemented with peroral premedication.