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Query: UMLS:C0038379 (strabismus)
 9,317 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Oculocardial reflex (OCR) occurs particularly through manipulation of the medial rectus muscle and results in a bradycardic arrhythmia. In children the incidence is between 60 and 80%. After using sevoflurane in clinical practice, the absence or non-occurrence of this reflex was observed. The data of 180 healthy children aged between four and 14 years who had to undergo strabismus surgery under general anaesthesia were analysed: group I (n = 92), group II (n = 88). All children received standard premedication with midazolam, no anticholinergic drugs were administered. During narcosis, analgesia was maintained routinely with alfentanil. In group I sevoflurane was inhaled for hypnosis and in group II propofol was injected as intravenous hypnotic drug. The depth of anaesthesia was adjusted according to clinical criteria. To compare both groups, heart rate (HR) was determined before, during and after surgical intervention. OCR was defined as a heart rate declining by more than 20% from the initial HR.OCR is described in all methods of general anaesthesia. Under sevoflurane the occurrence of the reflex was significantly (p < 0.05) reduced to 14% of all patients as compared to 75% in patients who received a propofol infusion. Sufficient reflex reduction according to the depth of narcosis under sevoflurane in combination with the sympathomimetic effects of this drug could therefore be discussed as a reason for its positive effects. In our opinion, the use of sevoflurane should be considered as an option for general anaesthesia in strabismus surgery.
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PMID:[Effects of sevoflurane versus propofol on oculocardiac reflex--a comparative study in 180 children]. 1072 Nov 97

Most penetrating or lacerating injuries of the eye in children justify examination under anesthesia to avoid further harm to an uncooperative patient. The pediatrician in doubt should merely apply a sterile dressing and have an ophthalmologist examine the injury in hospital. Nonperforating injuries may result in severe bleeding 48 to 72 hours later; this may be averted by bandaging the eyes and maintaining rest for four or five days. Removal of foreign bodies should be followed by application of antibiotic ointment and patching to prevent contamination. Congenital stenosis of the lacrimal duct may clear spontaneously or through application of decongestants and sympathomimetic drops. More severe effects, especially infection, justify probing at six months or earlier. The operation should be done under general anesthesia, preferably in hospital.Acute conjunctivitis is best treated by local application of antibiotics or sulfonamides only. Chronic infections may be better managed with the addition of corticosteroids, which reduce local inflammation and control bacterial reaction. Bacterial study should be done only if empirical antibiotic therapy fails. Bacterial desensitization may be helpful. The same methods are effective in blepharitis, aided by hygienic measures. Corticosteroids are most useful in allergic inflammations.Refractive difference is difficult to test before a child can read, and apparent defects may be due to lack of cooperation. Marked inequality of the eyes may signify organic disorder. Strabismus, on the other hand, can be detected as early as 12 or 15 months and should be treated as early as possible by proper lenses, surgery, or both. Pediatricians and parents should be aware that many children appear to have strabismus because of wide epicanthi and deep-set eyes.
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PMID:Common eye problems in children. 1385 98