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$Subcutaneous Trigeminal Nerve Field Stimulation for Refractory Facial Pain$

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Trigeminocardiac reflex in the Postanesthesia care unit.

Laura B Hemmer¹, Sherif Afifi, Antoun Koht

¹Department of Anesthesiology, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611, USA.

Journal of Clinical Anesthesia

|April 20, 2010

Summary

The trigeminocardiac reflex can cause bradycardia during surgery via cranial nerve V. This reflex, particularly from the mandibular division, can also cause unstable bradycardia in patients experiencing trigeminal neuralgia pain.

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Area of Science:

Anesthesiology
Neurology
Cardiology

Background:

Bradycardia during surgery is often linked to the oculocardiac reflex, involving the ophthalmic division of the trigeminal nerve.
The trigeminocardiac reflex, affecting other trigeminal nerve divisions, is less commonly recognized but can also induce bradycardia intraoperatively.

Observation:

This case presents unstable bradycardia during trigeminal neuralgia pain episodes.
The bradycardia was associated with stimulation of the mandibular division of the trigeminal nerve in the Postanesthesia Care Unit.

Findings:

The trigeminocardiac reflex, specifically involving the mandibular division of cranial nerve V, can precipitate significant bradycardia.
This reflex can manifest even outside the operating room, such as in the Postanesthesia Care Unit.

Implications:

Understanding the trigeminocardiac reflex is crucial for managing bradycardia in diverse clinical settings.
This highlights the importance of considering neurological stimuli when managing cardiovascular instability, even post-surgery.