Regular ArticleTrigeminocardiac reflex: a unique case of recurrent asystole during bilateral trigeminal sensory root rhizotomy
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Cited by (58)
Asystole induced by trigeminocardiac reflex during zygomatic fracture repositioning: A rare case report
2023, Journal of Oral and Maxillofacial Surgery, Medicine, and PathologyCitation Excerpt :Therefore, bony manipulation from the repositioning of the zygomatic fracture fragment could cause indirect pressure changes to the eyeball; this may serve as the initiation of TCR that eventually leads to asystole. Communication between the operating oral-maxillofacial surgeons and anesthesiologists, especially during sensitive portions, such as elevation of the zygoma or manipulation of the orbit/orbital segments, should be maintained [24]. In the event of bradycardia, immediate cessation of the surgery to avoid further surgical stimulus and preparation for chest compression, using atropine or glycopyrrolate, and local anesthetic blockade of the afferent nerves for an asystolic event are recommended [16,25].
Asystole Triggered by the Mouth Opening With a Dental Mouth Gag Under General Anesthesia During Pediatric Oral Surgery: Report of a Rare Case
2021, Journal of Oral and Maxillofacial SurgeryCitation Excerpt :Although a dental mouth gag is commonly used during oral surgery, asystole is rarely induced by the gag. The trigeminovagal reflex sometimes manifests during surgical procedures, particularly in eye surgery7 and otolaryngology surgery,8 but this reflex was also triggered by maxillofacial surgery,4,9 cerebellopontine angle surgery,5 microvascular trigeminal decompression,6 facial injury,10 and sleep bruxism.11 It has been reported that the incidence of trigeminovagal reflex in maxillofacial surgical procedures is approximately 1.6%.12
The trigeminocardiac reflex: Does the activation pathway of its efferent arc affect the intensity of the hemodynamic drop during the management of maxillofacial fractures?
2021, Journal of Cranio-Maxillofacial SurgeryCitation Excerpt :The same is also reported about the manipulation of the fractured segments, which leads to mechanical stretch painful stimuli with a high strength (Kosaka et al., 2001; Lübbers et al., 2010)). Also, the nature of the stimuli is the largest potential risk factor that evokes the TVR, where the sustained and abrupt traction is able to elicit the TVR more than gentle and smooth traction as reported by Cha et al. (2002). The ophthalmic nerve is also indirectly stimulated during the release of the entrapped inferior rectus muscle through the manipulation of the ciliary ganglion via long and short ciliary nerves.
The Trigeminocardiac Reflex During the Anterior Transpetrosal Approach
2017, World NeurosurgeryThe Trigeminal Nerve: Anatomical Pathways. Trigeminocardiac Reflex Trigger Points
2015, Trigeminocardiac ReflexHistory of the Trigeminocardiac Reflex: An Odyssey
2015, Trigeminocardiac Reflex
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Hrayr K. Shahinian M.D. Skull Base Institute, Cedars-Sinai Medical Center, 8635 West Third Street, Suite 490W, Los Angeles, CA 90048, USA Tel: 1 310 423 8091 Fax: 1 310 423 8791 E-mail: [email protected]