Paediatric anaesthesia & critical care
Neuromuscular Blockade Depth and Oculocardiac Reflex in Pediatric Strabismus Surgery: A Randomized Clinical Trial
Primary result · OCR grade ≥2Result — go to the resultOdds ratio 0.37 95% CI 0.21–0.66Authors' conclusion
Moderate to deep neuromuscular blockade significantly reduced both the incidence and severity of OCR during pediatric strabismus surgery compared with minimal to shallow blockade.
Study context
- Population
- Pediatric patients aged 3 to 18 yr undergoing strabismus surgery under GA201 analysed
- Participants
- 204 patients
- Comparison
- Moderate to deep vs minimal to shallow NMB
- Moderate to deep neuromuscular blockade (MD-NMB)n = 99
- Minimal to shallow neuromuscular blockade (MS-NMB)n = 102reference
- Primary endpoint
- Incidence of oculocardiac reflex (OCR) grade ≥2 (heart rate decrease from baseline ≥20%)
Methodological detailsprospective, double-blinded
- Prospective
- Double-blinded
Primary result
OCR grade ≥2
Odds ratio
0.37
95% CI 0.21–0.66
P = 0.001
By group
MD-NMB vs MS-NMB
OR 0.37 (95% CI 0.21–0.66); P = 0.001
As reported in the abstract
Secondary outcomes
| Outcome | MD-NMB | MS-NMB | OR (95% CI) | P value | |
|---|---|---|---|---|---|
| Severe OCR (grade ≥3, heart rate decrease ≥30%) | 18.2% | 35.3% | 0.41 (0.21–0.78) | P = 0.007 | |
| 0.20.5125Odds ratio (log scale) |
Duration of heart rate reduction (patients with OCR) · smaller in the MD-NMB group
P = 0.024
| Outcome | MD-NMB | MS-NMB | P value |
|---|---|---|---|
| Magnitude of heart rate reduction (patients with OCR)Smaller in the MD-NMB group | 28.0% (interval 18.2–35.9%) | 34.3% (interval 26.9–42.6%) | P = 0.003 |
Original publication
Neuromuscular Blockade Depth and Oculocardiac Reflex in Pediatric Strabismus Surgery: A Randomized Clinical Trial. Anesthesiology. Published 16 July 2026. doi:10.
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