Abstract
Purpose: To determine whether the changes in the ocular alignment following general anesthesia, maintained with two different inhalational anesthetic agents, sevoflurane and desflurane, can be used as a predictor for surgical outcomes in children with esotropia. Methods: The authors obtained digital photographs of 42 children with esotropia; 21 patients underwent strabismus surgery with general inhalation anesthesia with sevoflurane (group A), 21 patients with inhalatory anesthesia with desflurane (Group B), as maintenance general anesthesia agents. For each patient, the corneal reflexes position were digitally measured and compared with the preoperative ocular deviation’s angle; the correlation with surgical outcome, one year after, was considered. Results: The patients in both groups showed a decrease of the squint angle, or eye’s gap position after the induction of general anesthesia. In group B, this divergence was significantly higher than in group A (P 1 SD. Conclusion: Changes in the ocular deviation with sevoflurane and desflurane, can be predictive for surgery outcome in children with esotropia. Furthermore, desflurane evidenced greater effects on the ocular deviation compared to sevoflurane, thus confirming to be the inhalational anesthetic of choice in strabismus surgery.
Highlights
General anesthesia alters the eyeball’s position in squint patients, as well as in orthophoric one’s [1]
The results suggest that the enhancement of non-depolarizing muscle relaxants induced neuromuscular blockade by volatile anesthetics could be induced in part by a combined effect of these drugs on the nicotinic acetylcholine receptor (nAChR) [4]
Forty-two patients with convergent strabismus were divided in two groups: 21 patients were subjected to the strabismus surgery under general inhalation anesthesia with sevoflurane, 21 patients under inhalation anesthesia with desflurane
Summary
General anesthesia alters the eyeball’s position in squint patients, as well as in orthophoric one’s [1]. As far as interaction between volatile anesthetics and neuromuscular blockers is concerned, it was hypothesized that muscle relaxation could be the result of combined drug effects on the nicotinic acetylcholine receptor (nAChR). The results suggest that the enhancement of non-depolarizing muscle relaxants induced neuromuscular blockade by volatile anesthetics could be induced in part by a combined effect of these drugs on the nAChR [4]. Recent results suggest that sevoflurane and isoflurane reduce sodium-dependent synaptic vesicle exocytosis by blocking Na+ sodium channels sensitive to tetrodotoxin at the mouse neuromuscular junctions, with skeletal muscle relaxation [5]. Recent studies enhanced the first direct action on presynaptic ion channels, filling the gap between neurochemical studies on anesthetic effects on transmitter release [3]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
