Prophylactic Use Of Different Doses Atropine To Reduce Oculo-Cardiac Reflex In School-age Children During Strabismus Surgery

Objective:To explore the preventive effect of different doses of atropine on ocular reflex in school-age children with strabismus correction,compare the effectiveness of reducing ocular reflex in school-age children with strabismus correction,and compare the incidence of adverse reactions,and obtain appropriate anesthesia induction dose and give The drug time,thus providing a certain clinical basis for the reasonable application of atropine to prevent eye reflex in squint correction for school-age children undergoing short surgery.Method:100 children with school-age strabismus who underwent elective general anesthesia strabismus surgery at the Fourth Affiliated Hospital of Kunming Medical University from October 2018 to March 2019 were randomly divided into three groups according to the dose of atropine.30 patients in group A were not given atropine,30 patients in group B were given 0.005 mg.kg-1 atropine,and 40 patients in group C were given 0.01 mg.kg-1 atropine.Group B and C were divided into B1,B2 and C1,C2 groups according to the time of administration,15 cases in each subgroup of group B,20 cases in each subgroup of group C,and B1 and C1 groups.For administration at the time of induction,the B2 and C2 groups were administered 5-10 minutes before the start of surgery.In the induction of anesthesia,sequential intravenous sufentanil 0.3ug.kg-1,medium long-chain propofol 2.5-3mg.kg-1,atracurium 0.5mg.kg-1,atropine as above,connect anesthesia The machine is mechanically ventilated and the parameters are adjusted according to age and weight.During the operation,2.5%sevoflurane was inhaled to maintain anesthesia,and PETC02 was maintained at 27-32 mmHg.The same anesthesia depth is maintained according to the adjustment of the surgical stimulation intensity.After the child has spontaneous breathing and consciousness recovery,the tracheal tube is removed.No other drugs are added during the operation without special circumstances.The operation of the tracheal intubation in this trial was performed by a physician with the title of the attending physician and above.Observe and record when the child enters the room(TO),when the catheter is intubated(T1),at the beginning of the operation(T2),5 minutes after the start of surgery(T3),10 minutes(T4),15 minutes(T5),end of surgery(T6),and extubation Vital signs,Sp02 and MAP,recorded the start time of anesthesia,administration time,operation time,extubation time,number of eye reflexes during operation,minimum heart rate,and other adverse reactionsResults:The actual number of observations was 100,of which 46 were male and 54 were female.There were no significant differences in gender,weight and age between the five groups(P>0.05).At different time points and different time points,the change of heart rate was analyzed by variance analysis(ANOVA).The heart rate baseline value and the lowest HR were not statistically significant(P>0.05).There was no statistical significance between the groups except TO(P>>0.05),the remaining time points,T1,T2,T3,were statistically significant(P<0.05).The incidence of ocular reflex(OCR)was different in the five groups,with a high incidence of unpreventive use of the atropine group and no severe tachycardia in the atropine group.At different time points and different time points,the changes of mean arterial pressure data were analyzed by repeated data ANOVA.There was no statistical significance(P>0.05)except T0.The remaining time points,P<0.05,were statistically significant.The percentage of HR increase in the B1 and C1 groups and in the B2 and C2 groups was significantly higher than that in the A group(P<0.05),indicating that the dose was 0.005 mg/kg more stable than the 0.01 mg/kg center rate.For the group,the difference between the B1 and B2,C1 and C2 groups was statistically significant(P<0.05),indicating that the heart rate fluctuations were less than 5-10 minutes before the induction.The preoperative five groups of A,B1,B2,C1,and C2 were compared by repeated ANOVA in the operation time and extubation time,and there was no statistical significance(P>0.05).Conclusion:For strabismus correction in school-age children with a operative time<1h,prophylactic use of atropine can reduce the incidence of ocular reflexes.Intravenous administration 5-10 minutes before surgery has less effect on heart rate during intubation than induction.The dosage rate of 0.005 mg.kg-1 is more stable than that of 0.01 mg.kg-1.