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Oculocardiac reflex during endoscopic brow lift: A case report
1BLS Surgery Center, Bangkok, Thailand.
Background:
The oculocardiac reflex (OCR) is a trigeminovagal reflex most commonly associated with ophthalmic surgery. Its occurrence in aesthetic facial procedures is rarely reported.
Case Presentation:
A 44-year-old woman with no underlying medical conditions underwent elective endoscopic brow lift under general anesthesia using volatile anesthetic agents. Baseline heart rate was 90 beats per minute. During traction near the right supraorbital rim, severe bradycardia occurred with heart rate dropping to 20 beats per minute. The event resolved after cessation of traction and administration of intravenous atropine. Similar bradycardia recurred during left-sided supraorbital traction and again during sustained forehead fixation, demonstrating a reproducible reflex response, with atropine required for resolution of the final episode.
Conclusion:
This case highlights that OCR may occur repeatedly during endoscopic brow lift due to supraorbital nerve manipulation. Awareness and prompt management are essential for patient safety.
