Ketamine and the oculocardiac reflex. Dysrhythmia in pediatric strabismus surgery: the role of intravenous atropine

Abstract

Fifty children in the age-group 1.75-10 years, admitted for cure of strabismus, were anaesthetised with intramuscular ketamine. Half the patients, at random, were given intravenous atropine, while anaesthetised, 5 minutes before operative interference. ECG recording of Lead 2 showed an oculacardiac dysthythmic response to muscle pull in 19 of the 25 unatropinised patients. The atropinised patients failed to show evidence of muscle induced dysrhythmia in any of the subjects (0%) The 25 control traces in the atropinised subjects showed no dysrhythmia after 5 minutes, but the possible immediate transitory dysrhythmic effects of atropine in the presence of ketamine anaesthesia is the subject of further study.