Botulinum neurotoxins (BoNTs) cause flaccid paralysis by interfering with vesicle fusion and neurotransmitter release in the neuronal cells. BoNTs are the most widely used therapeutic proteins. BoNT/A was approved by the U.S. FDA to treat strabismus, blepharospam, and hemificial spasm as early as 1989 and then for treatment of cervical dystonia, glabellar facial lines, axillary hyperhidrosis, chronic migraine and for cosmetic use.
Hypnosis is an effective tool in many areas of medicine and surgery. The exacting demands of ophthalmic surgery require good patient cooperation and strict adherence to treatment regimens. Multisystemic diseases compounded by the physiological stress of surgery make it essential that already strained homeostatic mechanisms are interfered with minimally. The cases presented in this report illustrate the beneficial use of hypnosis in the treatment of several high risk patients in unusual situations.
The authors describe the case of a mentally very labile boy suffering from strabism. When he was excited, the deviation of the affected eye increased, diplopia, nausea and headache developed. Hypnosis was applied and the condition improved after 12 sessions. His behaviour changed and progress in school improved. The authors draw attention to new therapeutic possibilities of some forms of strabism in mentally labile children by application of hypnosis.
Oculocardial reflex (OCR) occurs particularly through manipulation of the medial rectus muscle and results in a bradycardic arrhythmia. In children the incidence is between 60 and 80%. After using sevoflurane in clinical practice, the absence or non-occurrence of this reflex was observed. The data of 180 healthy children aged between four and 14 years who had to undergo strabismus surgery under general anaesthesia were analysed: group I (n = 92), group II (n = 88). All children received standard premedication with midazolam, no anticholinergic drugs were administered.
We conducted a double-blind, randomized, placebo-controlled study to investigate the effectiveness of P6 acupuncture on postoperative vomiting in children undergoing strabismus surgery. Acupuncture was performed by laser stimulation with a low-level laser. Laser stimulation of P6 was administered 15 min before induction of anaesthesia and 15 min after arriving in the recovery room. In the laser stimulation group, the incidence of vomiting was significantly lower (25%) than that in the placebo group (85%).