Oculocardiac reflex as a predictive sign of postoperative nausea and vomiting following strabismus surgey in children

Background In this prospective, non-randomized study, we tested the hypothesis if oculocardiac reflex (OCR) can be used as a predictor of postoperative nausea and vomiting following strabismus surgery in children. Methods 88 children aged between 2 and 16 years undergoing strabismus surgery were enrolled in the study between 2009 and 2011. All anaesthetic drugs were given in a specific sequence using propofol, ondansetron, and fentanyl. Sevofurane, N2O/O2 used to maintain anaesthesia. All children received intravenous fluid maintenance, intravenous diclofenac, as well as subtenon block. The incidence of oculocardiac reflex as well as postoperative nausea and vomiting were recorded. Results 76 patients developed OCR during surgery (86.4 %).There was no evidence of an association between OCR and postoperative nausea/vomiting (PONV). There was no evidence between the number of muscles operated on and PONV. Furthermore, there was no evidence of association between children who received atropine to treat bradycardia and reduction in the incidence of PONV. None of our patients required overnight admission. Conclusions PONV following strabismus surgery in children is low and cannot be predicted from OCR. It seems that boys are more likely to develop PONV compared to girls.