Unanticipated Asystole During Maxillofacial Surgery Due to Activation of the Trigeminocardiac Reflex: What are the Modulating Effects of Intravenous Ketamine and Remifentanil?

Trigeminocardiac reflex (TCR) is the paroxysmal dysautonomia that results from manipulation of the sensory branches of the fifth cranial nerve, resulting in gastric hypermotility, cardiac dysrhythmias, asystole, and bradycardia. It is considered to be a maxillary and mandibular manifestation of the oculocardiac reflex (OCR). Authors have attempted to stratify the surgical risk for TCR based on published cases. However, the role of specific anesthetic agents in modulating TCR remains incompletely understood.

Source: Journal of Oral and Maxillofacial Surgery - September 30, 2020 Category: ENT & OMF Authors: J.H. Masi, A. Champion Source Type: research