In an attempt to investigate clinically some of the possible etiologic factors contributing to cardiac arrest during ocular surgery and to study potential means of their prevention, electrocardiography has been performed in the operating room on a series of patients undergoing various types of intraocular and extraocular operations under both local and general anesthesia.
Our interest in this problem was first aroused in 1955, when one of us (R. E. K.) experienced the death of a patient during surgery for retinal detachment wherein fatal cardiac arrest developed shortly after the preliminary manipulation of two extraocular muscles. A review of the literature concerning the potential relationship between ocular surgery and cardiac arrhythmias revealed many basic facts but also bared many areas of deficiency in our understanding of this relationship and, most important to us, very little evidence as to means of prevention of cardiac arrest in eye surgery. It is toward
KIRSCH RE, SAMET P, KUGEL V, AXELROD S. Electrocardiographic Changes During Ocular Surgery and Their Prevention by Retrobulbar Injection. AMA Arch Ophthalmol. 1957;58(3):348-356. doi:10.1001/archopht.1957.00940010360005