Document Detail


Comparison of the effects of atropine and labetalol on trigeminocardiac reflex-induced hemodynamic alterations during percutaneous microballoon compression of the trigeminal ganglion.
MedLine Citation:
PMID:  23385037     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: A significant abrupt drop in heart rate is the most frequent complication during percutaneous microballoon compression of the trigeminal ganglion. It is suggested that co-activation of the sympathetic and parasympathetic nervous systems plays an important role in this occurrence. We hypothesized that not only atropine, but also labetalol might be effective in preventing this cardiovascular reflex during percutaneous microballoon compression of the trigeminal ganglion.
METHODS: Patients who underwent percutaneous microballoon compression for trigeminal neuralgia between September 2007 and December 2009 were prospectively evaluated. The relationship between the hemodynamic changes and intraoperative use of atropine (0.01 mg/kg) or labetalol (0.05 mg/kg) was compared. One-way analysis of variance with Bartlett's and Tukey's post-tests was used, and a value of p < 0.05 was considered statistically significant.
RESULTS: In total, 119 patients who received percutaneous microballoon compression for trigeminal neuralgia were studied, of whom 38 received atropine before ganglion compression, 36 received labetalol, and 45 received normal saline as a control. Of the patients who received normal saline, 31.3% had moderate bradycardia (heart rate < 50 beats/min), 13.3% had severe bradycardia (heart rate < 40 beats/min), and 7% had arrhythmia. Of the patients who received atropine, 7.8% had moderate bradycardia, 7.8% had arrhythmia, and 5.3% had postcompression tachycardia by the end of ganglion compression. Of the patients who received labetalol, 16.7% had moderate bradycardia, 5.6% had severe bradycardia, and 2.8% had arrhythmia. Systemic blood pressure was markedly elevated straight after compression in all groups and tended to normalize 3 minutes afterwards.
CONCLUSION: Both atropine and labetalol were able to lower the frequency of bradycardia. Neither of them could abolish episodes of bradycardia during the procedure. Patients receiving labetalol before microballoon compression were subject to a smaller change in hemodynamics. Our findings verified that the sympathetic and parasympathetic nervous systems may be involved in the complex interneuronal interaction of the trigeminocardiac reflex.
Authors:
Chun-Yu Chen; Chiao-Fen Luo; Yi-Chun Hsu; Jyi-Feng Chen; Yuan-Ji Day
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Publication Detail:
Type:  Journal Article     Date:  2013-01-16
Journal Detail:
Title:  Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists     Volume:  50     ISSN:  1875-452X     ISO Abbreviation:  Acta Anaesthesiol Taiwan     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2013-02-06     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101214918     Medline TA:  Acta Anaesthesiol Taiwan     Country:  China (Republic : 1949- )    
Other Details:
Languages:  eng     Pagination:  153-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2012. Published by Elsevier B.V.
Affiliation:
Department of Anesthesiology, Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC; Transgenic and Molecular Immunogenetics Laboratory, Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC; Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan, ROC.
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