Trigeminocardiac reflex in the Postanesthesia care unit

Hemmer, Laura B.; Afifi, M Sherif; Koht, Antoun

doi:10.1016/j.jclinane.2009.03.017

Cited by 11 publications

(7 citation statements)

References 15 publications

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“…There are three significant findings in this review about chronic TCR ( 11 – 16 ). First, the peripheral TCR was the commonest type, and the OCR was the most common subtype associated with the chronic form of TCR.…”

Section: Discussionmentioning

confidence: 89%

“…This was an octogenarian male patient who underwent a microvascular decompression for a trigeminal neuralgia and developed multiple episodes of bradycardia in postoperative period, and these intermittent adverse cardiovascular changes persisted for several days ( 11 ). This patient also developed an event of cardiac arrest and was resuscitated with chest compressions.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Chronic Trigemino-Cardiac Reflex: An Underestimated Truth

Chowdhury

Schaller

2017

Front. Neurol.

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The trigemino-cardiac reflex (TCR) is a brainstem reflex that manifests as adverse cardiorespiratory events upon the stimulation of sensory branches of the fifth cranial nerve. This reflex is mainly investigated in different neurosurgical procedures and intervention. This reflex is commonly considered as an acute and mild physiological response. On the other hand, more devastating and chronic nature of this reflex is largely underreported and unknown. Therefore, this article aims to provide the comprehensive understanding of the chronic form of TCR, its manifestations, and management by literature search. Also, this paper would certainly impart a better diagnosis and understanding of TCR phenomenon by knowing the relatively less common form of a chronic TCR. This will help thousands and thousands of patients who are still in the phase of diagnosis and are suffering from vague symptoms related to this reflex.

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Section: Discussionmentioning

confidence: 89%

Section: Resultsmentioning

confidence: 99%

Chronic Trigemino-Cardiac Reflex: An Underestimated Truth

Chowdhury

Schaller

2017

Front. Neurol.

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“…The majority of reports state that patients with bradycardia or asystole recover after discontinuing the manipulation or administration of anticholinergics like atropine or glycopyrrolate [ 1 , 3 ]. But some reports state that the use of epinephrine, a temporary pacemaker or a cardiac massage was needed upon the failure of atropine to treat the TCR [ 6 , 13 , 14 , 15 ]. The dose of epinephrine varies in the reports from 5 µg [ 13 ] to 1 mg [ 6 , 14 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…But some reports state that the use of epinephrine, a temporary pacemaker or a cardiac massage was needed upon the failure of atropine to treat the TCR [ 6 , 13 , 14 , 15 ]. The dose of epinephrine varies in the reports from 5 µg [ 13 ] to 1 mg [ 6 , 14 , 15 ]. Therefore in cases with the TCR, the use of epinephrine, a pacemaker or a cardiac massage should be considered upon the failure of atropine.…”

Section: Discussionmentioning

confidence: 99%

Trigemino-cardiac reflex: occurrence of asystole during trans-sphenoidal adenomectomy: a case report

Jeon

Kang

Hur

2014

Korean J Anesthesiol

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The trigemino-cardiac reflex has been reported to occur during various craniofacial surgeries or procedures including manipulation of the trigeminal ganglion, tumor resection in the cerebellopontine angle, various facial reconstructions and trans-sphenoidal adenomectomy. Regarding risk factors during trans-sphenoidal adenomectomy, invasiveness closely related to the size of tumor and the degree of manipulation of cavernous sinus wall have been reported. We report the case of a 40-year-old female patient who had a relatively small-sized (< 10 mm) pituitary adenoma. Repetitive asystoles occurred during microscopic trans-sphenoidal operation of the wall of the cavernous sinus, which strongly suggests the importance of careful manipulation of the cavernous sinus wall. In addition to reporting this rare complication of trans-sphenoidal adenomectomy, we reviewed its clinical management by performing a literature search.

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“…This reflex has been described related to ophthalmic surgical procedures or ophthalmic trauma. 6,7 We postulate that the relationship of the ophthalmic branch of the trigeminal nerve to the cavernous sinus was the cause of bradycardia. To our knowledge, this is the first time that a CCF initially presented with symptomatic bradycardia.…”

Section: Commentsmentioning

confidence: 99%

Carotid-Cavernous Fistula Manifesting as Symptomatic Bradycardia: A Unique Presentation

Wadley

Patterson

Markowitz

et al. 2015

Neuro-Ophthalmology

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A 54-year-old female with vertigo and sarcoidosis presented to the emergency department with a 4-day history of generalised malaise, headache, fever, and near syncope. She was noted to have severe bradycardia and was admitted for possible pacemaker implantation. During the admission, the patient voiced left eye complaints, the workup of which revealed a left internal carotid aneurysm that ruptured, causing a direct carotid-cavernous fistula. The patient underwent multiple procedures to tamponade the fistula, and the bradycardia resolved, avoiding pacemaker implantation.

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Trigeminocardiac reflex in the Postanesthesia care unit

Cited by 11 publications

References 15 publications

Chronic Trigemino-Cardiac Reflex: An Underestimated Truth

Chronic Trigemino-Cardiac Reflex: An Underestimated Truth

Trigemino-cardiac reflex: occurrence of asystole during trans-sphenoidal adenomectomy: a case report

Carotid-Cavernous Fistula Manifesting as Symptomatic Bradycardia: A Unique Presentation

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