Document Detail


Trigemino-cardiac reflex during transsphenoidal surgery for pituitary adenomas: methodological description of a prospective skull base study protocol.
MedLine Citation:
PMID:  17428450     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A systematic clinical neuroscience protocol is described for the use to examine the trigemino-cardiac reflex (TCR) response in humans. Target neurosurgical conditions are operations that require manipulations around the peripheral and central part of the trigeminal nerve and its branches, e.g. the cerebellopontine angle or the sellar region. To assess the hemodynamic and cardiac responses of patients after TCR initiation, anesthetic monitoring has been applied. The TCR is defined as a drop of more than 20% of the heart rate and the mean arterial blood pressure compared with the baseline values before the stimulus and coinciding with the surgical manipulation at or around any branches of the trigeminal nerve. By help of illustrative cases, we present for the first time preliminary results regarding the differentiation of the TCR in a central and a peripheral induction during transsphenoidal surgery of pituitary adenomas. Based on these results, we can conclude that we have developed a battery of preoperative examination procedures based on event-related diagnostics that was useful to differentiate different subgroups of TCR during transsphenoidal surgery. The presented protocol can be performed directly pre-, intra- and postoperatively and applied for assessment of TCR even in patients with known risk factors.
Authors:
B J Schaller; D Weigel; A Filis; M Buchfelder
Publication Detail:
Type:  Case Reports; Journal Article     Date:  2007-01-12
Journal Detail:
Title:  Brain research     Volume:  1149     ISSN:  0006-8993     ISO Abbreviation:  Brain Res.     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-05-04     Completed Date:  2007-07-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0045503     Medline TA:  Brain Res     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  69-75     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, University of Göttingen, Germany. skull_base_surgery@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adenoma / surgery*
Adult
Anti-Arrhythmia Agents / therapeutic use
Atropine / therapeutic use
Blood Pressure / physiology
Clinical Protocols*
Female
Heart Rate / physiology
Humans
Hypotension, Orthostatic / etiology,  prevention & control
Intraoperative Complications / prevention & control*
Monitoring, Physiologic / methods*
Neurosurgical Procedures / adverse effects,  methods
Pituitary Neoplasms / surgery*
Prospective Studies
Reflex / physiology*
Skull Base / surgery
Sphenoid Sinus / surgery
Syncope, Vasovagal / etiology,  prevention & control
Tachycardia / etiology,  prevention & control
Trigeminal Nerve / physiopathology,  surgery
Chemical
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 51-55-8/Atropine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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