Trigemino-cardiac reflex may be refractory to conventional management in adults

Prabhakar, Hemanshu; Ali, Zulfiqar; Rath, Girija Prasad

doi:10.1007/s00701-008-1516-y

Cited by 43 publications

(29 citation statements)

References 5 publications

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“…It has been reported that nerve block taken in conjunction with anticholinergics, completely abolished the occurrence of the occulocardiac reflex in extraoccular muscle surgery [23]. In cases refractory to vagolytic agents epinephrine has been advocated [24]. Sudden asystole without preceding bradycardia has also been reported which has responded to simple cessation of insult [25].…”

Section: Maxillofacial Surgery and Trigeminocardiac Reflexmentioning

confidence: 99%

Trigeminocardiac Reflex: A Reappraisal with Relevance to Maxillofacial Surgery

Bhargava

Thomas

Chakravorty

et al. 2013

J. Maxillofac. Oral Surg.

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Purpose The purpose of this paper was to undertake a review of literature on trigeminocardiac reflex in oral and maxillofacial online data-base and discuss the pathophysiology, risk factor assessment, presentation of the reflex, prevention, management with emphasis on the role of the attending anaesthetist and the maxillofacial surgeon. Materials and Methods The available literature relevant to oral and maxillofacial surgery in online data-base of the United States National Library of Medicine: Pubmed (http://www.ncbi.nlm.nih.gov/pubmed/) was searched. The inclusion criterion was to review published clinical papers, abstracts and evidence based reviews on trigeminocardiac reflex relevant to oral and maxillofacial surgery. Results Sixty-five articles were found with the search term ''trigeminocardiac reflex'' in the literature searched. Eighteen articles met the inclusion criteria for this study. The relevant data was extracted, tabulated and reviewed to draw evidence based conclusions for the management of trigeminocardiac reflex. Conclusions Conclusions were drawn and discussed based on the reviewed maxillofacial literature with emphasis on the anaesthetist's and the surgeon's role in the management of this detrimental event in maxillofacial surgical practice.

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Section: Maxillofacial Surgery and Trigeminocardiac Reflexmentioning

confidence: 99%

Trigeminocardiac Reflex: A Reappraisal with Relevance to Maxillofacial Surgery

Bhargava

Thomas

Chakravorty

et al. 2013

J. Maxillofac. Oral Surg.

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“…As the TCR is now better known, we realize that not every bradycardia is a TCR [1] and that is why we publish only cases in which we have excluded hemodynamic changes not related to TCR by our own strict definition [5][6][7]. Regarding the case of the question of colleague Prabahakar, he speaks of a "sudden cardiac standstill" [2], but various differential diagnoses exist for a cardiac arrest during skin flap elevation. To decide such cases, we should await a larger case series before making further decisions.…”

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confidence: 99%

Letter to the Editor: Peripheral trigemino-cardiac reflex

Schaller¹,

Filis

Sandu

et al. 2009

Acta Neurochir

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We have read with great interest the commentary of our colleague Prabhakar on our recent manuscript about the first description of the trigemino-cardiac reflex (TCR) [4]. However, he claims to have previously seen a peripheral TCR in his own series [3]. As the TCR is now better known, we realize that not every bradycardia is a TCR [1] and that is why we publish only cases in which we have excluded hemodynamic changes not related to TCR by our own strict definition [5][6][7]. Regarding the case of the question of colleague Prabahakar, he speaks of a "sudden cardiac standstill" [2], but various differential diagnoses exist for a cardiac arrest during skin flap elevation. To decide such cases, we should await a larger case series before making further decisions. We need to conduct prospective studies with real-time second-tosecond monitoring of the heart rate and blood pressure in conjunction with possible monitoring of the vagal activity so that we can determine a definite time and causal relationship between hemodynamic parameters and vagal activity. Acta Neurochir

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“…Prabhakar et al reported a 48-year-old female who developed severe bradycardia and hypotension during craniotomy for parietal convexity meningioma; she was unresponsive to atropine and successfully managed with epinephrine. [6] This important case report underlines the fact that TCR may be refractory to atropine and other vagolytic agents should be considered instead. Our patient was not hypertensive and had no structural heart disease; however, his intraoperative blood pressure was labile.…”

Section: Discussionmentioning

confidence: 89%

Cardiac Dysrhythmia During Superficial Parotidectomy.

Aliyeva¹,

Rustamzade²,

Aliyev³

2017

Azerbaijan Med Assoc J

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Bradycardia and asystole due to the trigeminocardiac reflex can occur during several maxillofacial, skull base and ophthalmic procedures.We describe a case where severe bradycardia occurred during superficial parotidectomy. The case report is presented to show a possible existence and importance of reflex bradycardic responses that may occur during surgical procedures involving the parotid gland and their management.

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Trigemino-cardiac reflex may be refractory to conventional management in adults

Cited by 43 publications

References 5 publications

Trigeminocardiac Reflex: A Reappraisal with Relevance to Maxillofacial Surgery

Trigeminocardiac Reflex: A Reappraisal with Relevance to Maxillofacial Surgery

Letter to the Editor: Peripheral trigemino-cardiac reflex

Cardiac Dysrhythmia During Superficial Parotidectomy.

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