| Trigemino-cardiac reflex: the trigeminal depressor responses during skull base surgery. | |
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MedLine Citation:
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PMID: 18514393 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To observe and analyze the occurrence and management of the trigemino-cardiac reflex (TCR) defined as the phenomenon of abrupt drops in heart rate (HR) and blood pressure during skull base surgery. METHOD: One hundred patients underwent skull base surgery for various lesions were recruited and great attention was paid to heart rate and blood pressure throughout the surgical procedure to screen intraoperative TCR. RESULT: Twelve patients had TCR intro-operatively, all patients showed abrupt drops in HR of 38% from a mean of 78 beats/min to a mean of 49 beats/min, mean arterial blood pressure (MABP) decreased 33% from a mean of 93 mmHg to a mean of 60 mmHg, respectively. TCR was resolved spontaneously in eight patients, but had to be offset by intraoperative administration of relatively higher dose atropine in another four patients. CONCLUSION: (1) Manipulation at or near the trigeminal nerve during the skull base surgery may cause TCR, even if premedication with anticholinergic drug is used; (2) cessation of irritation from surgical manipulation to disrupt the reflex is the most important step to offset TCR; (3) continuous, especially repeated TCR in some rare cases occasionally necessitates the administration of high dose atropine. |
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Authors:
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Qingli Meng; Yang Yang; Maode Zhou; Xingang Li |
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Publication Detail:
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Type: Journal Article Date: 2008-06-02 |
Journal Detail:
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Title: Clinical neurology and neurosurgery Volume: 110 ISSN: 0303-8467 ISO Abbreviation: Clin Neurol Neurosurg Publication Date: 2008 Jul |
Date Detail:
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Created Date: 2008-07-14 Completed Date: 2008-09-15 Revised Date: 2009-10-14 |
Medline Journal Info:
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Nlm Unique ID: 7502039 Medline TA: Clin Neurol Neurosurg Country: Netherlands |
Other Details:
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Languages: eng Pagination: 662-6 Citation Subset: IM |
Affiliation:
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Department of Neurosurgery, Qilu Hospital, Shandong University, Jinan, Shandong, PR China. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Anesthesia / methods Atropine / administration & dosage, therapeutic use Bradycardia / physiopathology, therapy Electrocardiography Female Heart / innervation, physiopathology Heart Rate / physiology Humans Hypotension / physiopathology, therapy Intraoperative Complications / physiopathology*, therapy Male Meningeal Neoplasms / surgery Meningioma / surgery Middle Aged Monitoring, Intraoperative Muscarinic Antagonists / administration & dosage, therapeutic use Neuroma, Acoustic / surgery Neurosurgical Procedures / methods Reflex, Oculocardiac / physiology* Skull Base / innervation, surgery* Skull Base Neoplasms / surgery Trigeminal Nerve / physiopathology* |
| Chemical | |
Reg. No./Substance:
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0/Muscarinic Antagonists; 51-55-8/Atropine |
| Comments/Corrections | |
Comment In:
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Clin Neurol Neurosurg. 2009 Feb;111(2):220
[PMID:
18996640
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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