El-Habbash S, Padaki P, Bayoumi S, Ross P
North Manchester General Hospital, Pennine Acute Hospitals NHS Trust , Manchester , UK.
Ann R Coll Surg Engl. 2018 Sep;100(7):e174-e175. doi: 10.1308/rcsann.2018.0087. Epub 2018 Jun 18.
The trigeminocardiac reflex is a rare occurrence in patients undergoing maxillofacial surgery, with a reported incidence of 1-2%. Clinical signs and symptoms include bradycardia, nausea, with further stimulation potentially leading to cardiac dysrhythmias, ectopic beats, atrioventricular blocks and asystole. Most maxillofacial procedures, including temporomandibular joint procedures, are considered low risk. We report the first case of a tender temporomandibular joint synovial cyst whose management was complicated by severe trigeminocardiac reflex resulting in asystole. We suggest that in such cases communication between surgeons and the anaesthesia team is of paramount importance and informing the anaesthetist intraoperatively prior to the manipulation of the capsule or temporomandibular joint meniscus is recommended in the prevention or successful treatment of this condition.
三叉神经心脏反射在接受颌面外科手术的患者中很少见，报道的发生率为1%-2%。临床体征和症状包括心动过缓、恶心，进一步刺激可能导致心律失常、异位搏动、房室传导阻滞和心搏停止。大多数颌面手术，包括颞下颌关节手术，被认为风险较低。我们报告了首例颞下颌关节滑膜囊肿患者，其治疗因严重的三叉神经心脏反射导致心搏停止而变得复杂。我们建议，在这种情况下，外科医生与麻醉团队之间的沟通至关重要，并且建议在术中操作关节囊或颞下颌关节半月板之前告知麻醉师，以预防或成功治疗这种情况。
