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Updated: Jun 2, 2026
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Subcutaneous Trigeminal Nerve Field Stimulation for Refractory Facial Pain
Published on: May 10, 2017
Trigeminocardiac reflex, bilateral sagittal split ramus osteotomy, Gow-Gates block: a randomized controlled clinical
Behnam Bohluli1, Bernhard J Schaller, Reza Khorshidi-Khiavi
1Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Azad University of Tehran, Tehran, Iran.
Summary
The Gow-Gates nerve block may prevent the trigeminocardiac reflex (TCR) during bilateral sagittal split ramus osteotomy. Pulse rate changes were significantly reduced on the blocked side during critical surgical steps.
Area of Science:
- Anesthesiology
- Oral and Maxillofacial Surgery
- Neurophysiology
Background:
- The trigeminocardiac reflex (TCR) behavior during maxillofacial surgeries is not well-understood.
- Existing knowledge is primarily based on limited case reports.
Purpose of the Study:
- To assess TCR occurrence during bilateral sagittal split ramus osteotomy (BSSO).
- To determine the effect of Gow-Gates mandibular nerve block on TCR incidence during BSSO.
Main Methods:
- Twenty patients undergoing BSSO received general anesthesia and a unilateral Gow-Gates nerve block.
- Pulse rate was monitored at various surgical stages (baseline, bone cutting, splitting, manipulation, recovery).
- A t-test compared pulse rates between the blocked and control sides.
Main Results:
- No significant difference in pulse rate between sides, except during ramus sagittal splitting and setback manipulation.
- A statistically significant decrease in pulse rate was observed on the control side compared to the blocked side during these specific maneuvers (P < .0001).
Conclusions:
- The Gow-Gates block may help prevent peripheral TCR during BSSO.
- Suggests potential differences in neurophysiologic pathways between peripheral and central TCR.
