Reflex bradycardia in facial surgery

Traction on, or stretching of, any structure innervated by the trigeminal nerve can cause reflex slowing of the pulse, inappropriately known as the "oculocardiac reflex" because it is well-known to result from traction on the extra-ocular muscles. This phenomenon can cause problems in surgery of the face and cranium as well as the orbit. An awareness of its management can obviate morbidity and mortality. An account of the phenomenon, its treatment and illustrative case histories are presented.