In Paediatric Anaesthesia --- Anticholinergic premedication is a must for any procedure. Complete Vagal block is strongly advised . I prefer Hyoscine ( Buscopan) for this. Hyoscine gives amnesia, anxiolysis, , sedation, in addition to Anticholinergic actions.Especially in Ophthalmology-- Squint , Cataract etc OCULO CARDIAC REFLEX shud be kept in mind . When both eyes are operated , Anticholinergic shud be given twice , ie for each eye seperately . Otherwise sudden bradycardia is frequently observed .
After this , an opioid in Adequate dose shud be given .I prefer Butorphanol 1-2 mg depending on anxiety, pain , duration of surgery etc . Now after this a small dose of ketamine 12.5 mg - 25 mg is administered. Retrobulbar block is administered. Spo2, HR etc are monitored. Surgery is started , only one more dose of ketamine may be required if at all. If the surgery is bilateral give…
