Brown J A, Preul M C
Department of Neurological Surgery, Medical College of Ohio, Toledo.
Neurosurgery. 1988 Dec;23(6):745-8. doi: 10.1227/00006123-198812000-00010.
Percutaneous microcompression of the trigeminal ganglion for trigeminal neuralgia was performed 23 times on 21 patients. Significant abrupt drops in heart rate and blood pressure (P less than 0.0002) occurred when the needle entered the foramen ovale or upon balloon advancement or inflation. In 16 of 23 (70%) procedures, the heart rate fell abruptly to 60 or less, by a mean of 38%. Mean arterial blood pressure decreased transiently by 31% during 12 of 23 (55%) procedures. Our findings of transient bradycardia and hypotension upon mechanical stimulation or compression of the mandibular nerve or trigeminal ganglion show for the first time the presence of a trigeminal depressor response in humans. We recommend that heart rate and arterial blood pressure be monitored continuously during percutaneous microcompression of the trigeminal ganglion. Intravenous atropine should be available for immediate use, and an external pacemaker should be fitted preoperatively.
对21例患者进行了23次经皮三叉神经节微压迫术治疗三叉神经痛。当穿刺针进入卵圆孔或球囊推进或充盈时，心率和血压出现显著急剧下降（P<0.0002）。在23例手术中的16例（70%），心率突然降至60次/分或更低，平均下降38%。在23例手术中的12例（55%），平均动脉血压短暂下降31%。我们发现，在下颌神经或三叉神经节受到机械刺激或压迫时出现短暂性心动过缓和低血压，这首次表明人类存在三叉神经降压反应。我们建议在经皮三叉神经节微压迫术期间持续监测心率和动脉血压。应备有静脉注射阿托品以供立即使用，术前应安装体外起搏器。
