Oculocardiac Reflex Strabismus — FRCA Final MCQ

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EasyPaediatric AnaesthesiaOculocardiac Reflex StrabismusFRCA Final

2-year-old undergoing strabismus surgery: HR drops from 120 to 50. Most likely cause?

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Correct answer: C — Oculocardiac reflex from extraocular muscle traction

Oculocardiac reflex: trigeminovagal reflex triggered by traction on extraocular muscles (especially medial rectus). Afferent V1, efferent vagus. Can cause profound bradycardia/asystole. Management: release traction, atropine 20 mcg/kg IV.

Reference: APAGBI – 2023 – Anaesthesia for paediatric ophthalmic surgery