Ophthalmic anaesthesia Flashcards Preview

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Flashcards in Ophthalmic anaesthesia Deck (7)
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1
Q

What is the average globe length?

A

23mm

2
Q

What constitutes a “long eye”?

A

> 26mm

3
Q

When is a “long eye” suspected?

A

Myopia (short sightedness)

4
Q

What procedures is the occulocardiac reflex most commonly seen?

A

Paediatric cases
Squint surgery
Vitreoretinal surgery

5
Q

What is the trigger for the occulocardiac reflex?

A

traction of the extraoccular muscles, especially the medial rectus, and pressure on the globe.

6
Q

Describe the course of the occulocardiac reflex.

A

tension on muscles -> long and short cilliary nerves synapse in the gasserion ganglion (short cilliary also traverses the cilliary ganglion) - > trigeminal nerve synapse in the brainstem at the sensory nucleus of the trigeminal nerve -> short intra nuchal fibres synapse in the vagus motor nerve -> vagus nerve projects to the SAN.

7
Q

What is a suitable pre-medicant for a paediatric case for prevention of the occulocardiac reflex.

A

Glycoperronium 4mcg/kg IM 30-60 mins pre-induction