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Sudden asystole due to trigeminocardiac reflex during transsphenoidal surgery for pituitary tumor

Authors
 Jin Mo Cho ; Kyung Tae Min ; Sun Ho Kim ; Min Chul Oh ; Eui Hyun Kim 
Citation
 World Neurosurgery, Vol.76(5) : 477e11~477e15, 2011 
Journal Title
 World Neurosurgery 
ISSN
 1878-8750 
Issue Date
2011
Abstract
BACKGROUND: A sudden attack of an asystolic phenomenon is an extremely rare event during transsphenoidal surgery (TSS). It may be caused by an extreme type of trigeminocardiac reflex (TCR) during the manipulation of the trigeminal nerve or its innervated structures. CASE DESCRIPTION: We report two cases of sudden asystole and a case of severe bradycardia due to TCR during TSS. All patients were managed successfully by cessation of the surgical manipulation or with the injection of an anticholinergic agent. CONCLUSIONS: Although TCR occurs rarely and usually is self-limiting, surgeons should be cautious of its occurrence, especially when manipulating the cavernous sinus during TSS. This allows the early detection and appropriate treatment of this manifestation. Stopping the surgical procedure as soon as TCR occurs is likely to normalize the vital parameters. In addition, if further manipulations are inevitable, the administration of anticholinergic medication should be considered cautiously to improve surgical outcomes.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/94709
DOI
10.1016/j.wneu.2011.01.043
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Anesthesiology and Pain Medicine
1. 연구논문 > 1. College of Medicine > Dept. of Neurosurgery
Yonsei Authors
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Link
 http://www.sciencedirect.com/science/article/pii/S187887501100091X
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