Trigemino-Cardiac Reflex During Orbital Floor Reconstruction: A Case Report and Review

Abstract

Trigemino-cardiac reflex is occurrence of hypotension and bradycardia upon surgical manipulation of areas supplied by the trigeminal nerve, and has been reported during craniofacial maxillofacial and ocular surgeries. Communication between the anaesthetic and surgical team is essential, and cessation of the precipitating stimulus is the first and most important therapeutic step. We report a case of immediate, reproducible, and reflexive response of Bradycardia and dysrhythmia upon manipulation of orbital fracture during orbital floor reconstruction in a 65-year-old man. Upon recognition of the reproducible relationship between falcine stimulation and increased vagal tone, the patient was given atropine in an effort to block cholinergic hyperactivity. After atropine administration, no further dysrhythmias occurred and surgery was carried uneventfully.

Asystole During Nasopharyngeal Swab: Is COVID-19 to Blame?

“…The nasocardiac, oculo-cardiac and the maxillo-mandibulo-cardiac reflex (V2-V3) are considered entities of the peripheral TCR [9]. There are several reports in the literature demonstrating vagally medicated cardiovascular effects including bradycardia after stimulation of the trigeminal nerve during ocular and maxillofacial surgeries [10,11].…”