Comparison of the Effect of Intravenous Atropine and Hyoscine on the Frequency of Oculocardiac Reflex in Scleral Buckling Surgery: A Triple-Blinded Randomized Clinical Trial
Abstract
Background: Oculocardiac reflex is a trigeminovagal reflex that occurs following mechanical manipulation of the orbital cavity. The current study evaluated the preventive effect of atropine and hyoscine on the Oculocardiac reflex in scleral buckling surgery.
Methods: In this triple-blinded randomized controlled clinical trial, a total of 75 patients candidated for scleral buckling surgery were divided into three groups. Intravenous atropine (0.02 mg/kg up to a maximum of 0.5 mg), hyoscine (0.2 mg/kg), and distilled water were injected after intubation for each group respectively with standard monitoring. Heart rate, blood pressure and/or cardiac dysrrythmia were recorded immediately before/after injection and every 10 minutes. Decrease of heart rate more than 20%, or any cardiac dysrrythmia were defined as OCR. P-value <0.05 was significant.
Results: Demographic parameters were not different in three groups. Oculocardiac reflex was observed in hyoscine (34.8%), atropine (31.6%) and control (35.3%) groups (p=0.27). Additive atropine was injected only in two patients of control group. Oculocardiac reflex occurred more in the first ten minutes (35%) and in 30 minutes (55%), and was not observed after 90 minutes. Moreover, atropine and hyoscine increased the heart rate of patients more than control group (P=0.02), but in atropine group was longer than hyoscine group (P=0.03). Systolic blood pressure was not significantly different among the groups.
Conclusion: In this study had been showed that in scleral buckling surgery, atropine is more effective than hyoscine in heart rate increase, but did not reduce oculocardiac reflex more significant than hyoscine and control group. And also oculocardiac reflex was more in first 30 minutes.
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