Maurya Harshita, Singh Vibha, Mohammad Shadab, Singh Geeta, Aggrawal Amiya, Gautam Shefali, Tiwari Tanmay
Department of Oral and Maxillofacial Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India.
Department of Anaesthesia and Critical Care Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India.
Natl J Maxillofac Surg. 2022 May-Aug;13(2):248-253. doi: 10.4103/njms.NJMS_334_21. Epub 2022 Jul 15.
The behavior of trigeminocardiac reflex (TCR) is limited to few case reports only in maxillofacial surgery, especially for temporomandibular joint (TMJ) ankylosis cases. The present study aims to find out the incidence of bradycardia due to TCR during intraoperative forceful mouth opening in TMJ ankylosis patients.
A prospective, unicentric observational study was conducted selecting those patients who were planned for osteoarthrectomy with interpositional gap arthroplasty under general anesthesia. Sixty cases of TMJ ankylosis were randomly selected from December 2018 to-03-2020. Predictor variables were patient age, gender, and type of ankylosis, and outcome variables were pulse rate, mean arterial blood pressure (MABP), and oxygen saturation level (SPO). Data were recorded at baseline and during intraoperative mouth opening via heister jaw stretcher. A Chi-square test was used for testing the association between variables. values were considered statistically significant at <0.05.
The sample size of 60 subjects has been divided into two age groups (10-19) years and (20-40) years. The mean standard deviation age of the patients was 18.32 ± 6.81 years. About 63.3% were male. Out of 60 cases, 14 patients developed bradycardia. The frequency of bradycardia was found 23.3%. According to logistic regression analysis, age and type of ankylosis were the significant predictors of bradycardia.
We conclude that bradycardia due to TCR in TMJ ankylosis patients is not an uncommon entity. Incidences are more prevalent in the age group of 10-19 years and type IV bony ankylosis. Male had a high incidence of bradycardia though value was nonsignificant.
三叉神经心脏反射（TCR）的表现仅在少数颌面外科病例报告中有记载，尤其是颞下颌关节（TMJ）强直病例。本研究旨在找出颞下颌关节强直患者术中强行开口时因TCR导致心动过缓的发生率。
进行了一项前瞻性、单中心观察性研究，选取计划在全身麻醉下进行骨切除术并植入间隙关节成形术的患者。从2018年12月至2020年3月随机选取60例颞下颌关节强直病例。预测变量为患者年龄、性别和强直类型，结果变量为脉搏率、平均动脉血压（MABP）和血氧饱和度水平（SPO）。在基线时以及术中通过海斯特颌骨撑开器开口时记录数据。采用卡方检验来检验变量之间的关联。P值<0.05被认为具有统计学意义。
60名受试者的样本被分为两个年龄组（10 - 19）岁和（20 - 40）岁。患者的平均标准差年龄为18.32±6.81岁。约63.3%为男性。60例病例中，14例患者出现心动过缓。心动过缓的发生率为23.3%。根据逻辑回归分析，年龄和强直类型是心动过缓的显著预测因素。
我们得出结论，颞下颌关节强直患者因TCR导致的心动过缓并非罕见情况。发生率在10 - 19岁年龄组和IV型骨性强直中更为普遍。男性心动过缓的发生率较高，尽管P值无统计学意义。
