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Coronary vasospasm during percutaneous trigeminal rhizotomy.
B Swerdlow1, L Shuer, J Zelcer
1Department of Anesthesia, Stanford University Medical Center, California 94305.
Anaesthesia
|October 1, 1988
Summary
A patient experienced myocardial infarction due to coronary vasospasm during percutaneous trigeminal rhizotomy. Prophylaxis with nitrates and calcium antagonists may prevent this complication.
Area of Science:
- Cardiology
- Neurology
- Interventional Pain Management
Background:
- Percutaneous trigeminal rhizotomy is a procedure to treat trigeminal neuralgia.
- The procedure can elicit a profound sympathetic response.
- Coronary vasospasm is a potential complication of procedures involving significant sympathetic activation.
Observation:
- A case of myocardial infarction occurred during percutaneous trigeminal rhizotomy.
- The myocardial infarction was attributed to coronary vasospasm.
- The event was associated with a significant sympathetic response.
Findings:
- Coronary vasospasm can be triggered by the sympathetic response during percutaneous trigeminal rhizotomy.
- Myocardial infarction is a serious consequence of this vasospasm.
- Invasive hemodynamic monitoring may be beneficial in identifying at-risk patients.
Implications:
- Patients undergoing percutaneous trigeminal rhizotomy, especially those with risk factors for coronary vasospasm, may benefit from prophylactic nitrates and calcium antagonists.
- Awareness of this potential complication is crucial for procedural safety.
- Further research into managing sympathetic responses during neuroablative procedures is warranted.