SynthesisMedicine2015
Anesthetic influence on occurrence and treatment of the trigemino-cardiac reflex: a systematic literature review.
Synthesis in Medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
35 citing papers in PubMed, 2 syntheses or guidelines pooled it, 72 citations in OpenAlex.
- Pooled it
- Pooled it
- Comparison of Remimazolam and Propofol for Intravenous Anesthesia on Trigeminocardiac Reflex in Percutaneous Balloon Compression for Trigeminal Neuralgia: A Randomized Controlled Trial.Drug design, development and therapy · 2024Trial
- Prophylactic intra-arterial injection of lidocaine: a novel strategy to prevent endovascular embolization-induced trigeminocardiac reflex.Journal of neurointerventional surgery · 2023Trial
- The effect of anesthesia depth on the oculocardiac reflex in strabismus surgery.Journal of clinical monitoring and computing · 2016Trial
- Oculocardiac Reflex during Electrode Placement in Trigeminal Schwannoma Surgery via Cavernous Sinus Approach.Asian journal of neurosurgery · 2026Article
- Article
- Anaesthesia for resection of vestibular schwannoma.BJA education · 2025Review
- Bradycardia and hypotension associated with trigeminocardiac reflex during orthognathic surgery: two case reports.Annals of medicine and surgery (2012) · 2025Article
- Exploring the trigeminocardiac reflex: an integrated view from mechanism to clinic.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2025Review
- Review
- Association of Lower Age and Cardiorespiratory Events during Intra-Arterial Chemotherapy for Retinoblastoma: A Prospective Observational Study.AJNR. American journal of neuroradiology · 2023Observational
- Prognostic factors for trigeminocardiac reflex during cerebrovascular intervention operation.Frontiers in surgery · 2022Article
- Prophylactic Intra-Arterial Injection of Lidocaine Prevents Trigeminocardiac Reflex During Endovascular Embolization for Dural Arteriovenous Fistula: A Report of 2 Cases.The American journal of case reports · 2021Article
- Case report: 2 cases of cardiac arrest caused by rhino-cardiac reflex while disinfecting nasal cavity before endonasal transsphenoidal endoscopic pituitary surgery.BMC anesthesiology · 2021Article
- The Oculocardiac Reflex: A Review.Clinical ophthalmology (Auckland, N.Z.) · 2021Review
- Anesthetic Impacts on the Oculocardiac Reflex: Evidence from a Large, Observational Study.Clinical ophthalmology (Auckland, N.Z.) · 2021Article
- Intra-Arterial Lidocaine Blunts the Trigeminocardiac Reflex during Endovascular Treatment of a Carotid-Cavernous Fistula.Case reports in anesthesiology · 2021Article
- Trigeminocardiac Reflex Induced by Maxillary Nerve Stimulation during Sphenopalatine Ganglion Implantation: A Case Series.Brain sciences · 2020Article
- Pulmonary Aspiration During Induction of General Anesthesia.Anesthesia progress · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Trigeminocardiac reflex (TCR) is defined as sudden onset of parasympathetic dysrhythmia including hypotension, apnea, and gastric hypermotility during stimulation of any branches of the trigeminal nerve. Previous publications imply a relation between TCR and depth of anesthesia. To gain more detailed insights into this hypothesis, we performed a systematic literature review.Literature about occurrence of TCR was systematically identified through searching in Cochrane Central Register of Controlled Trials (CENTRAL), PubMed (MEDLINE), EMBASE (Ovid SP), and the Institute for Scientific Information (ISI Web of Sciences) databases until June 2013, as well as reference lists of articles for risk calculation. In this study, TCR was defined as drop in mean arterial blood pressure and heart rate, both >20% to baseline. We calculated intraoperative cerebral state index (CSI) of each TCR-case using a newly developed method. These data were further divided into 3 subgroups: CSI <40 (deep anesthesia), CSI 40-60 (regular anesthesia), and CSI >60 (slight anesthesia).Including 45 studies with 910 patients, 140 (15%) presented with TCR, and 770 (85%) without TCR during operation. TCR occurrence showed a 1.2-fold higher pooled risk slighter anesthesia (CSI <40: 13%, at CSI 40-60: 21%, and at CSI >60: 27%) compared with deeper anesthesia. In addition, we could discover a 1.3-fold higher pooled risk of higher MABP drop with a strong negative correlation (r = -0.935; r = 0.89) and a 4.5-fold higher pooled risk of asystole during TCR under slight anesthesia compared with deeper anesthesia.Our work is the first systematic review about TCR and demonstrates clear evidence for TCR occurrence and a more severe course of the TCR in slight anesthesia underlying the importance of skills in anesthesia management during skull base surgery. Furthermore, we have introduced a new standard method to calculate the depth of anesthesia.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.