Arnold RW, Jansen S, Seelig JC, et al. - Researchers conducted this prospective, observational cross-sectional, double-cohort study to describe the impact on oculocardiac reflex (OCR) by the anesthesiologist. Using a uniform 10-second, 200-gram square wave tension on each extraocular muscle, the oculocardiac reflex was prospectively observed during routine, community outpatient general anesthetic strabismus surgery from 1992 to 2019. Various opioids, muscle relaxants, and inhalational agents had a substantial effect on OCR. Linear regression exhibited a significant inhibitory impact on OCR by increased inhalational agent depth and by lower exhaled CO ₂. With enough anticholinergics, deeper inhalational agents, and robust ventilation, the anesthesiologist will block OCR and augment it with opioids, dexmedetomidine, and apparently even dexamethasone.