Chowdhury Tumul, Ahuja Nitin, Schaller Bernhard
From the Department of Anesthesiology and Perioperative Medicine, University of Manitoba, Winnipeg, Manitoba (TC, NA); and Department of Research, University of Southampton, Southampton, UK (BS).
Medicine (Baltimore). 2015 Dec;94(49):e2118. doi: 10.1097/MD.0000000000002118.
Hemodynamic alterations are observed in various neurosurgical procedures and commonly related to different neurogenic mechanisms. However, anesthetic influences on causation of these perturbations or management are rarely investigated and therefore our present knowledge is still limited.In this case of 43-old Caucasian male, propofol boluses aborted the trigeminal cardiac reflex (TCR) induced severe bradycardia during dural manipulation. There is a correlation of severity of bradycardia and slightness of anesthesia.In the light of the larger distribution of the TCR all over the world, we see more and more aborted TCR, as seen in the present case; then the neuro-anesthesists more and more recognize the TCR at its very onset. A surrogate model for the daily use is present to underline the clinical needs.We have therefore developed, for the first time, a surrogate model that helps in daily practice to recognize and prevent TCR episodes.
在各种神经外科手术中均观察到血流动力学改变，且通常与不同的神经源性机制有关。然而，麻醉对这些紊乱的起因或处理的影响很少被研究，因此我们目前的认识仍然有限。在这位43岁的白种男性患者中，丙泊酚推注终止了硬脑膜操作期间三叉神经心脏反射（TCR）诱发的严重心动过缓。心动过缓的严重程度与麻醉深度存在相关性。鉴于TCR在全球范围内分布更广，如本病例所见，我们看到越来越多的TCR被终止；那么神经麻醉医生越来越早地识别出TCR。目前存在一个日常使用的替代模型来强调临床需求。因此，我们首次开发了一个替代模型，有助于在日常实践中识别和预防TCR发作。
