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Trigeminocardiac reflex in pediatric adenotonsillectomy: A report of two cases with literature review
Author(s) -
Li Lilun,
Lin Connie,
Peña Maria,
Challa Chaitanya
Publication year - 2020
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.28016
Subject(s) - medicine , bradycardia , anesthesia , reflex , oculocardiac reflex , retractor , stimulation , heart rate , surgery , blood pressure
Trigeminocardiac reflex (TCR) is a physiological response that occurs due to stimulation of the trigeminal nerve, resulting in vagus nerve activation, parasympathetic dysrhythmia, and sympathetic hypotension. The pediatric population is vulnerable to TCR due to higher resting vagal tone, which can result in ischemia and death. This study reports two cases of TCR during adenotonsillectomy. Placement and rapid opening of a Crowe‐Davis retractor led to immediate bradycardia and hypotension in two children undergoing adenotonsillectomy, which resolved upon release of the retractor. Early intraoperative recognition of TCR with removal of mechanical stimulation can resolve vital instability without need for chemical intervention. Laryngoscope , 130:803–805, 2020