{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:17:26Z","timestamp":1787771846752,"version":"build-2784847793"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"Abstract<\/jats:title>\n \n Background:<\/jats:title>\n Oculocardiac reflex (OCR) is one of the serious complications following surgical therapeutic procedures for strabismus. Various medications have been tested to prevent or mitigate this complication. We aimed to compare the effect of intravenous atropine and topical tetracaine on the incidence and severity of OCR in strabismus surgery.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n In this triple-blind randomized clinical trial study, 120 patients who were candidates for strabismus surgery were randomly assigned to receive intravenous atropine, topical tetracaine, or artificial tears as the control. The incidence of OCR and its severity along with the changes in hemodynamic conditions were compared across the groups.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n The incidence rate of OCR in the groups receiving atropine, tetracaine, and the control was found to be 17.5%, 25.0%, and 32.5% in the releasing phase without any difference, respectively (\n P<\/jats:italic>\n = 0.303); however, it was 2.5%, 7.5%, and 25.0%, respectively, in the cutting phase, indicating a lower rate in the group receiving tetracaine (\n P<\/jats:italic>\n = 0.004). Similarly, there was no difference in the severity of OCR across the three study groups in the releasing phase (\n P<\/jats:italic>\n = 0.666); however, in the cutting phase, OCR was revealed to be milder in the group receiving atropine as compared to other groups (\n P<\/jats:italic>\n = 0.033). Prescribing atropine led to higher mean systolic blood pressure and mean arterial pressure during surgery.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n The injection of atropine can effectively reduce the incidence of OCR during strabismus surgery and reduce its severity if this reflex occurs.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/abr.abr_167_23","type":"journal-article","created":{"date-parts":[[2024,1,31]],"date-time":"2024-01-31T03:00:45Z","timestamp":1706670045000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Comparing Effectiveness and Safety of Intravenous Atropine with Topical Tetracaine in Preventing and Relieving Oculocardiac Reflex in Patients Undergoing Strabismus Surgery: A Randomized Clinical Trial"],"prefix":"10.4103","volume":"13","author":[{"given":"Darioush","family":"Moradi Farsani","sequence":"first","affiliation":[{"name":"Department of Anesthesia and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seyed Ehsan","family":"Shakerinia","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,1]]},"reference":[{"key":"R1-20240830","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1080\/08820538.2022.2070027","article-title":"A comparison of the long-term surgical outcomes of horizontal strabismus surgery between resident clinic and private clinic patients","volume":"37","author":"Dakroub","year":"2022","journal-title":"Semin Ophthalmol"},{"key":"R2-20240830","doi-asserted-by":"crossref","first-page":"1646","DOI":"10.1016\/j.ophtha.2018.04.024","article-title":"Strabismus, strabismus surgery, and reoperation rate in the 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Ophthalmol"},{"key":"R13-20240830","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/09273972.2018.1561732","article-title":"Reduction of oculocardiac reflex with Tetracaine eye drop in strabismus surgery","volume":"27","author":"Rahimi Varposhti","year":"2019","journal-title":"Strabismus"},{"key":"R14-20240830","first-page":"317","article-title":"The effect of tetracaine eyedrop versus placebo on oculocardiac reflex in strabismus surgery","volume":"36","author":"Rahimi","year":"2018","journal-title":"J Isfahan Med Sch"},{"key":"R15-20240830","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/j.jaapos.2007.01.124","article-title":"The effect of topical tetracaine eye drops on emergence behavior and pain relief after strabismus surgery","volume":"11","author":"Anninger","year":"2007","journal-title":"J AAPOS"},{"key":"R16-20240830","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1093\/bja\/54.10.1059","article-title":"I. M. or IV. atropine or glycopyrrolate for the prevention of oculocardiac reflex in children undergoing squint surgery","volume":"54","author":"Mirakhur","year":"1982","journal-title":"Br J Anaesth"},{"key":"R17-20240830","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1093\/bja\/aem145","article-title":"Comparison of desflurane with sevoflurane for the incidence of oculocardiac reflex in children undergoing strabismus surgery","volume":"99","author":"Oh","year":"2007","journal-title":"Br J Anaesth"},{"key":"R18-20240830","doi-asserted-by":"crossref","first-page":"30:1","DOI":"10.1111\/j.1365-2044.2008.05731.x","article-title":"Remifentanil in paediatric anaesthetic practice","volume":"64","author":"Marsh","year":"2009","journal-title":"Anaesthesia"},{"key":"R19-20240830","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1111\/j.1460-9592.2000.00588.x","article-title":"Effect of different anaesthetic regimes on the oculocardiac reflex during paediatric strabismus surgery","volume":"10","author":"Hahnenkamp","year":"2000","journal-title":"Pediatr Anesth"}],"container-title":["Advanced Biomedical Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/abr.abr_167_23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T18:17:27Z","timestamp":1787768247000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/abr.abr_167_23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":19,"URL":"https:\/\/doi.org\/10.4103\/abr.abr_167_23","relation":{},"ISSN":["2277-9175"],"issn-type":[{"value":"2277-9175","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1]]},"assertion":[{"value":"2023-05-16","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-30","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}