Abstract
Trigeminocardiac reflex: Can theneuro-anaesthesiologist afford to be complacent?
Highlights
Trigeminocardiac reflex (TCR) is a unique autonomic brainstem reflex that manifests as sudden cardiac dysrhythmia, hypotension and gastric hypermotility because of the stimulation of the trigeminal nerve or any of its branches.[1]
Neurosurgery involving the trigeminal nerve or any of its branches such as microvascular decompression, posterior fossa surgery and skull base surgery is a potential trigger for this reflex.[4]
The incidence of TCR may range from 1% to 2% in craniofacial surgery and 8%–18% during skull base surgery to more than 90% in ophthalmic manipulations without anticholinergic administration.[4]
Summary
Trigeminocardiac reflex (TCR) is a unique autonomic brainstem reflex that manifests as sudden cardiac dysrhythmia (bradycardia), hypotension and gastric hypermotility because of the stimulation of the trigeminal nerve or any of its branches.[1]. There is a sizeable literature on oculocardiac reflex during ophthalmic surgeries, which is recognised as a peripheral and physiological subtype of TCR.
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