Abstract
We thank Dr. Arnold for his interest and comments regarding our study. In our study—as you may see in the title—the effect of premedication on only postoperative nausea and vomiting (PONV) was investigated. Neither the effect of diazepam–atropine use on OCR occulocardiac reflex nor the relation between OCR and PONV were investigated.The number of patients with OCR were given only as findings in our study. Some are studies have shown OCR and PONV to have some connection, and some have not.1Allen L.E. Sudesh S. Sandramouli S. et al.The association between the oculocardiac reflex and post-operative vomiting in children undergoing strabismus surgery.Eye. 1998; 12: 193-196Crossref PubMed Scopus (36) Google Scholar Because we had a small number of subjects in our study, we did not comment on this matter. In addition, we think if the number of cases were to be increased, we could obtain different results in both groups.OCR is known and accepted as a 20% decrease in heart rate at the baseline, dysrhythmia, or sinoatrial arrest.2Allison C.E. De Lange J.J. Koole F.D. Zuurmond W.W. Ros H.H. van Schagen N.T. A comparison of the incidence of the oculocardiac and oculorespiratory reflexes during sevoflurane or halothane anesthesia for strabismus surgery in children.Anesth Analg. 2000; 90: 306-310PubMed Google Scholar Anesthetic protocols can effect this reflex in different stages by effecting the cholinergic or the adrenergic phase. OCR is rarely seen in procedures using sevoflurane anesthesia, whereas it is commonly seen in procedures using propofol anesthesia.3Goerlich T.M. Foja C. Olthoff D. Effects of sevoflurane versus propofol on oculocardiac reflex—a comparative study in 180 children.Anaesthesiol Reanim. 2000; 25: 17-21PubMed Google Scholar, 4Tramer M.R. Sansonetti A. Fushs-Buder T. et al.Oculocardiac reflex and postoperative vomiting in paediatric strabismus surgery. A randomised controlled trial comparing four anaesthetic techniques.Acta Anaesthesiol Scand. 1998; 42: 117-123Crossref PubMed Scopus (39) Google Scholar We agree with Dr. Arnold's comments regarding the influence of extraocular muscle tension on OCR. However, we did not plan to reveal the effect of extraocular muscle tension on OCR in our study. We thank Dr. Arnold for his interest and comments regarding our study. In our study—as you may see in the title—the effect of premedication on only postoperative nausea and vomiting (PONV) was investigated. Neither the effect of diazepam–atropine use on OCR occulocardiac reflex nor the relation between OCR and PONV were investigated. The number of patients with OCR were given only as findings in our study. Some are studies have shown OCR and PONV to have some connection, and some have not.1Allen L.E. Sudesh S. Sandramouli S. et al.The association between the oculocardiac reflex and post-operative vomiting in children undergoing strabismus surgery.Eye. 1998; 12: 193-196Crossref PubMed Scopus (36) Google Scholar Because we had a small number of subjects in our study, we did not comment on this matter. In addition, we think if the number of cases were to be increased, we could obtain different results in both groups. OCR is known and accepted as a 20% decrease in heart rate at the baseline, dysrhythmia, or sinoatrial arrest.2Allison C.E. De Lange J.J. Koole F.D. Zuurmond W.W. Ros H.H. van Schagen N.T. A comparison of the incidence of the oculocardiac and oculorespiratory reflexes during sevoflurane or halothane anesthesia for strabismus surgery in children.Anesth Analg. 2000; 90: 306-310PubMed Google Scholar Anesthetic protocols can effect this reflex in different stages by effecting the cholinergic or the adrenergic phase. OCR is rarely seen in procedures using sevoflurane anesthesia, whereas it is commonly seen in procedures using propofol anesthesia.3Goerlich T.M. Foja C. Olthoff D. Effects of sevoflurane versus propofol on oculocardiac reflex—a comparative study in 180 children.Anaesthesiol Reanim. 2000; 25: 17-21PubMed Google Scholar, 4Tramer M.R. Sansonetti A. Fushs-Buder T. et al.Oculocardiac reflex and postoperative vomiting in paediatric strabismus surgery. A randomised controlled trial comparing four anaesthetic techniques.Acta Anaesthesiol Scand. 1998; 42: 117-123Crossref PubMed Scopus (39) Google Scholar We agree with Dr. Arnold's comments regarding the influence of extraocular muscle tension on OCR. However, we did not plan to reveal the effect of extraocular muscle tension on OCR in our study.
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