Trigeminal cardiac reflex in faciomaxillary surgery
Journal Title: Al Ameen Journal of Medical Sciences - Year 2019, Vol 12, Issue 2
Abstract
Background: Trigeminocardiac reflex is a physiologic response of the body to pressure effects in the region of distribution of the trigeminal nerve. Since oral and maxillofacial surgical procedures can induce the development of this reflex as most of them are in the distribution of trigeminal nerve, which leads to significant changes in the heart rate and sinus rhythms. This study intends to evaluate the effects of this reflex in patients with facial fractures and its subsequent management. Methods: A total of 40 patients with facial fractures who presented to department of Oral and Maxillofacial Surgery Govt Dental College Srinagar. Results: A male preponderance is observed with the most susceptible age group being 21–30 years. Fractures included 19 zmc fractures 9 leefort fractures and 12 mandibular fractures. A relative bradycardia was observed in the patients with midfacial trauma during the surgical reduction of midfacial fractures, which improved after completion of procedure in most of the patients. However, in one patient, the bradycardia progressed to a cardiac asystole during midface manipulation necessitating immediate halt of the procedure and intravenous administration of atropine. Conclusion: Trigeminocardiac reflex though physiologic, which usually tends to subside without complications is not to be neglected in the surgeries of the maxillofacial skeleton. A propensity for unforeseen complications due to this reflex has to be avoided by meticulous electrocardiography monitoring.
Authors and Affiliations
Altaf H Malik, Shabnum Majeed, Mubashir Younis, Ajaz A Shah
Keywords
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