In ophthalmic surgery, surgical operations such as pulling certain eye tissues or compressing the eyeball often leads to bradycardia, arrhythmia even cardiac arrest, bradypnea, nausea and vomiting and elevated blood sugar level. The condition is called the ocularvagal reflex (OVR). Traditionally, when the bradycardia or arrhythmia happens, the operation has to be suspended, and atropine or isoproterenol is given intravenously to treat the bradycardia. Vagus nerve block may be an effective way to prevent and alleviate this vagal reflex. However it is difficult to perform the nerve block with anatomical landmark (blind) methods. In this study, the investigators used ultrasound-guided right cervical vagus nerve block to reduce the incidence of the OVR. The researchers hypothesized that low concentrations of lidocaine or ropivacaine can block the right cervical vagus nerve and reduce the incidence of intraoperative OVR. Researchers evaluated the changes of heart rate, blood pressure, oxygen saturation, and airway pressure in patients undergoing high-risk OVR surgery.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
60
Before the operation starts, patients received the ultrasound guided vagus nerve block. A 50mm Braun nerve stimulation needle is guided by the ultrasonic beam to insert into the carotid sheath and 10ml of lidocaine or ropivacaine is injected.
If the OVR happens because the surgical stimulation, the operation suspends and atropine (0.01-0.02mg/kg) or isoproterenol (1-2 μg/per time)is given intravenously to increase the heart rate.
Daping Hospital, Army Medical University
Chongqing, Chongqing Municipality, China
RECRUITINGChanges of heart rate
Changes of heart rate in beat per minute from Baseline
Time frame: during the operation
Changes of Blood pressure
Changes of systolic blood pressure in mmHg from Baseline
Time frame: during the operation
Changes of Peak airway pressure
Changes of Blood pressure in mmHg from Baseline
Time frame: during the operation
Changes of SpO2
Changes of SpO2 in percentage in mmHg from Baseline
Time frame: during the operation
Nausea and vomiting in times
Time frame: 24 hours after the operation
Voice changes in grades (0-3)
Changes of Voice changes in grades (0-3) from Baseline. 0 means good, 2 means moderate change of voice, 3 means hoarse voice
Time frame: 24 hours after the operation
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