Trigemino Cardiac Reflex: An Anesthetic Challenge In Oral And Maxillofacial Surgery

Abstract

The Trigeminocardiac Reflex (TCR) is characterized by sudden hypotension and dysrhythmia triggered by manipulation of the trigeminal nerve's branches, often starting as

bradyarrhythmias and potentially leading to asystole. This reflex, particularly noted during maxillofacial surgeries, raises significant concern among surgical and anesthetic teams. The

response involves vagal nerve activation caused by pressure on the trigeminal nerve, resulting in bradycardia, bradypnea, and altered gastrointestinal motility. TCR affects the entire

trigeminal nerve and was previously referred to as the oculocardiac reflex. Various surgical procedures, including temporomandibular joint arthroscopy and midface disimpaction, can induce TCR. This paper aims to explore TCR's pathophysiology, risk factors, treatment,

prevention, and management strategies, emphasizing the important roles of anesthetists and maxillofacial surgeons in its management. Awareness and understanding of TCR’s

presentations and preventative measures are crucial for maxillofacial surgeons to mitigate its impacts