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Profound trigeminocardiac reflex from lingual nerve stimulation: a case report
1Oral and Maxillofacial Surgery, Thomas Jefferson University, Philadelphia, USA.
Journal of Dental Anesthesia and Pain Medicine
|February 16, 2022
Summary
The trigeminocardiac reflex (TCR) can cause cardiac arrest during dental procedures. Anesthesia choices may influence TCR, necessitating careful medication selection and prompt recognition.
Area of Science:
- Anesthesiology
- Neurology
- Cardiology
Background:
- The trigeminocardiac reflex (TCR) is a brainstem reflex involving the trigeminal nerve.
- It typically causes cardiovascular changes like hypotension and bradycardia.
- TCR is most common during ophthalmic, orbital, and neurological surgeries.
Observation:
- This case details an asystolic TCR triggered by lingual nerve stimulation.
- Lingual nerve stimulation is a rare cause of TCR.
- The patient experienced asystole, a complete cessation of cardiac electrical activity.
Findings:
- Specific anesthetic medications can modulate the trigeminocardiac reflex.
- The choice of anesthesia is critical in managing TCR.
- Early recognition and communication are vital for patient safety.
Implications:
- Anesthesia providers should consider avoiding or discontinuing certain medications during procedures with even low TCR risk.
- This case underscores the importance of vigilance for TCR, even in less common scenarios.
- Improved understanding of TCR modulation can enhance patient outcomes in neurosurgery and dentistry.
