Document Detail

Trigeminocardiac reflex, bilateral sagittal split ramus osteotomy, Gow-Gates block: a randomized controlled clinical trial.
MedLine Citation:
PMID:  21511380     Owner:  NLM     Status:  MEDLINE    
PURPOSE: The behavior of trigeminocardiac reflex (TCR) during maxillofacial surgeries has not yet been sufficiently studied and knowledge of its behavior is limited to some case reports. The present study aimed to assess the occurrence of TCR in bilateral sagittal split ramus osteotomy and to determine the possible effect of Gow-Gates block on its incidence.
MATERIALS AND METHODS: Twenty candidates for bilateral sagittal split ramus osteotomy (included were American Society of Anesthesiologists I Class III patients with a prognathism of 3 to 5 mm) were given routine general anesthesia after at least 12 hours of fasting. All patients received Gow-Gates mandibular nerve block on 1 random side (case ramus; the other side was used as the control) after induction of general anesthesia before surgery. Pulse rate was recorded at baseline, soft tissue cutting, bone cutting, sagittal splitting, setback manipulation, and recovery. Mean pulse rate values were compared statistically using t test for the 2 sides in patients.
RESULTS: No statistically significant differences were found between the blocked and control sides except during ramus sagittal splitting and setback manipulation (P < .0001), when a significantly decreased pulse rate was recorded for the control ramus compared with the blocked ramus.
CONCLUSIONS: The present study provides further evidence for the complex neurophysiologic mechanism and probable prevention of peripheral TCR. The results of the present study should be further validated through future studies but already provide strong evidence that peripheral and central TCR may act differently based on slightly different pathways.
Behnam Bohluli; Bernhard J Schaller; Reza Khorshidi-Khiavi; Mohsen Dalband; Pooyan Sadr-Eshkevari; Peter Maurer
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2011-04-21
Journal Detail:
Title:  Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons     Volume:  69     ISSN:  1531-5053     ISO Abbreviation:  J. Oral Maxillofac. Surg.     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-08-26     Completed Date:  2011-10-17     Revised Date:  2011-10-27    
Medline Journal Info:
Nlm Unique ID:  8206428     Medline TA:  J Oral Maxillofac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2316-20     Citation Subset:  AIM; D; IM    
Copyright Information:
Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Azad University of Tehran, Tehran, Iran.
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MeSH Terms
Anesthesia, General
Anesthetics, Local / administration & dosage
Bradycardia / etiology*,  prevention & control*
Cross-Over Studies
Double-Blind Method
Heart Rate
Lidocaine / administration & dosage
Mandible / surgery*
Mandibular Nerve / drug effects
Monitoring, Intraoperative
Nerve Block / methods*
Orthognathic Surgical Procedures / adverse effects*
Osteotomy / adverse effects
Prospective Studies
Trigeminal Nerve / physiology
Vagus Nerve / physiology
Young Adult
Reg. No./Substance:
0/Anesthetics, Local; 137-58-6/Lidocaine
Comment In:
J Oral Maxillofac Surg. 2011 Oct;69(10):2483-4; author reply 2484-5   [PMID:  21939808 ]

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

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