球後注射與眼球按摩所致心臟合併症―1例報告

Cardiac Complication after Retrobulbar Injection and Ocular Massage-One Case Report

鄧美琴(Mei-Chung Teng) ； 陳德照(Te-Tsaw Chen)

《中華民國眼科醫學會會刊》 19卷 (1980/05) Pp. 194-196

https://doi.org/10.30048/ACTASOS.198005.0030

摘要

木篇報告一例由於球後注射與眼球按摩而誘發眼心臟反射，導致心臟合併症。眼心臟反射可由許多情況誘發。在眼科手術中，無論全身麻醉或局部麻醉，此反射發生之概率很高。多數學者認為，使用球後麻醉或Atropine靜脈注射，可以抑制此反射發生。在缺氧或二氧化碳分壓增高的情況下，此反射更容易被誘發且呈現的症狀更嚴重，故於手術時，需給病人良好的換氣環境，在心電圖監視下進行手術，方可及早發現心搏過緩或其他合併症，以做適當的緊急處置。

並列摘要

This report presents a case of cardiac complication due to oculocardiac reflex evoked by retrobulbar injection and ocular massage.
Oculocardiac reflex may be evoked by stretching of ocular muscle, or by pressure on or within the eye ball. The trigeminal nerve is the afferent lime of this reflex; the efferent lime is the vagus nerve to the heart. Both retrobulbar anesthesia and intravenous atropine, either preoperative or during surgery are useful in controlling the oculocardiac reflex.
Hypoxia, hypercarbia, hyperpotassemia, and direct effect of certain anesthetic agents may contribute the severity of oculocardiac reflex by rapidly converting bradycardia to cardiac arrest or may increase the sensitivity of the patient to the reflex.
The incidence of oculocardiac reflex in eye surgery, whether under general or local anesthesia is high, to operate under constant E. K. G. monitoring for early detecting bradycardia or other arrhythmia and adequate ventilation, with or without O2 supplementation are indefeasible.

並列關鍵字

Oculocardiac reflex ； Akinesia ； Optical iridectomy ； Resuscitation ； Reticular formation ； Polysynaptic pathway