The prevention of reflex bradycardia during ophthalmic surgery.

This paper concerns the reflex effects on the heart of the application of traction to the extrinsic muscles of the eye. Relevant medical literature is reviewed, and a controlled investigation of the value of muscle relaxant drugs in the prevention of untoward vagal activity during eye surgery is described. Gallamine is shown to provide considerable protection by reason of its vagal-blocking activity and it is suggested that this drug be used during anaesthesia for procedures involving traction on the eye muscles. Careful observation of the pulse and the avoidance of hypoxia and hypercapnia are also recommended.