Trigeminocardiac reflex during surgery in the cerebellopontine angle

Abstract

The authors' results show the possibility of occurrence of a TCR during manipulation of the central part of the trigeminal nerve when performing surgery in the CPA.

Peribulbar block or topical application of local anaesthesia combined for paediatric strabismus surgery

“…The high incidence (94%) of trigemino-cardiac reflex in our control cases is not new [2], but of the possible reasons put forward by Schaller et al to explain this incidence, only a few are actually applicable in our study (and those that were, were unavoidable). We ensured that our patients were not exposed to hypercarbia, hypoxia or light anesthesia by meticulously monitoring and maintaining SpO 2 and ETCO 2 within an acceptable range and by delivering 0.8% (nearly 1.3 MAC) inspired isoflurane.…”

“…Several pharmacological substances (e.g. gallamine, atropine) have been found already to more or less prevent the occurrence of this reflex during eye surgery [2,7], but no substance alone has completely suppressed it. A combination of intravenous atropine blocking the myocardial peripheral muscarinic receptor combined with retrobulbar xylocaine hydrochloride blocking conduction at the ciliary ganglion in the afferent limb of the trigemino-cardiac reflex, is effective in controlling it during eye surgery [8].…”

“…..................................................................................................................................................................................................................... reflex. The study also demonstrates the common problem of prophylaxis in the prevention of the intra-operative trigemino-cardiac reflex [2][3][4][5].…”

Letter to the Editor: Peripheral trigemino-cardiac reflex

“…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.…”

Trigeminocardiac Reflex after Direct Infusion of Chemotherapy into the Ophthalmic Artery for Retinoblastoma

“…In 1999, Schaller et al were the first to describe the TCR during a neurosurgical procedure. Their series of cerebellopontine angle tumor operations had an 11% incidence of TCR upon manipulation of the trigeminal nerve near the brainstem [17]. More recently, severe TCR leading to asystole during transsphenoidal surgery of the pituitary has also been reported [7,18].…”