Comparison of four non-depolarizing neuromuscular blocking drugs in the suppression of the oculocardiac reflex during strabismus surgery in children.

Eighty children (aged 2-12 yr) undergoing strabismus surgery were randomly assigned to receive tubocurarine, alcuronium, pancuronium or vecuronium during anaesthesia with thiopentone, fentanyl and nitrous oxide in oxygen. Heart rate and rhythm were recorded before and after the induction of anaesthesia and before and during traction on an extraocular muscle. End-tidal carbon dioxide concentration and the degree of neuromuscular blockade were monitored. Alcuronium seemed to give more protection against the oculocardiac reflex (defined as a 20% decrease in heart rate) than did tubocurarine, pancuronium or vecuronium.