Trigeminocardiac reflex: sudden severe bradycardia during open reduction for temporomandibular joint dislocation: A case report
10.17085/apm.2019.14.3.255
- Author:
Yeojung KIM
1
;
Youngkwon KO
;
Boohwi HONG
;
Yongsup SHIN
;
Chan NOH
;
Seounghun LEE
;
Seokhwan HONG
Author Information
1. Department of Anesthesiology and Pain Medicine, Chungnam National University College of Medicine, Daejeon, Korea. ane84@cnuh.co.kr
- Publication Type:Case Report
- Keywords:
Bradycardia;
Heart arrest;
Temporomandibular joint;
Trigeminal nerve;
Trigeminocardiac reflex
- MeSH:
Aged;
Anesthesia, General;
Atropine;
Bradycardia;
Dislocations;
Female;
Heart Arrest;
Heart Rate;
Humans;
Reflex, Trigeminocardiac;
Temporomandibular Joint;
Trigeminal Nerve
- From:Anesthesia and Pain Medicine
2019;14(3):255-258
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: The trigeminocardiac reflex (TCR), which occurs after stimulation of the territory of the trigeminal nerve, is very rarely reported to be caused by stimulation of the mandibular branch. We report a case of TCR in open reduction for temporomandibular joint (TMJ) dislocation. CASE: A 74-year-old female presented for TMJ dislocation. During open reduction of TMJ under general anesthesia, severe bradycardia (15 beats/min) occurred. Immediately 0.5 mg atropine was administered intravenously, and the surgical manipulation was stopped. After 30 seconds, heart rate normalized. During surgery, severe bradycardia occurred one more time. It disappeared spontaneously as soon as surgical manipulation was stopped. The surgery was completed uneventfully. CONCLUSIONS: Because of the possibility of profound bradycardia, asystole, or even death when evoked, it is important to be aware of the trigeminocardiac reflex during manipulation of the mandibular divisions, especially during surgical stimulation of the TMJ.
