A sudden cardiac asystole and cardiopulmonary resuscitation of trigeminocardiac reflex during retrosigmoid approach surgery

Excerpt

The trigeminocardiac reflex (TCR) is defined as the sudden onset of arrhythmias, hypotension, apnoea or gastric hypermotility during surgical manipulation at or around any branch of the trigeminal nerve [1]. TCR leads to a drop in mean arterial pressure and the heart rate of more than 20 % from the baseline values following stimulus resulting from manipulation of the trigeminal nerve [2]. Clinically, this phenomenon has reportedly occurred in craniofacial surgery for the fifth nerve, balloon compression or rhizolysis of the trigeminal ganglion or microvascular decompression, and surgery of lesions in the anterior, middle and posterior skull base [3]. In this report, a patient developed cardiac asystole during manipulation around the trigeminal nerve and effective cardiopulmonary resuscitative measures are required to resuscitate the patient. The awareness of TCR has been drawn during retrosigmoid approach surgery for brain tumor. …