The Effect of Pre-Emptive Dose of Intravenous Ketamine on Oculocardiac Reflex in Pediatric Strabismus Surgery: A Randomized Clinical Trial

Abstract

To evaluate the effect of pre-emptive dose of intravenous ketamine on Oculocardiac reflex (OCR) in pediatric strabismus surgery. 60 children with age between 2 to 8 years old candidate for strabismus surgery were randomly divided into two groups of 30 participants. After induction of anesthesia, in one group, pre-emptive dose of ketamine (0.15 mg/kg) was given intravenously (ketamine group), while the other group was given the same volume of normal saline (control group). During the surgery, OCR was recorded if the heart rate had decreased 20% or more from the baseline. In the recovery room, the incidence of nausea and vomiting, bronchospasm, laryngospasm, hallucination and recovery nurse satisfaction score were recorded. The incidence of OCR in total participants was 31 (51.7%). In control group 21 (70%) patients had OCR during surgery while this incidence was 10 (33.3%) in ketamine group which was significantly lower (P:0.004). the incidence of postoperative nausea and vomiting and the mean of recovery nurse satisfaction score in recovery room were not significantly different between two groups. The hallucination was not seen in any cases of two groups after surgery. The pre-emptive dose of ketamine (0.15 mg/kg) can reduce incidence of OCR in the pediatric strabismus surgery.