ArticleBMJ case reports2019
Sudden arrhythmia followed by bradycardia during sagittal split ramus osteotomy: trigeminocardiac reflex.
Article in BMJ case reports, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.
What it found
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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
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Who cites it
6 citing papers in PubMed, 2 syntheses or guidelines pooled it, 9 citations in OpenAlex.
- Trigeminocardiac reflex in bimaxillary orthognathic surgery: case review.Medicina oral, patologia oral y cirugia bucal · 2025Pooled it
- The protective role of lidocaine in surgeries involving trigeminal nerve manipulation: a meta-analysis of trigeminocardiac reflex prevention.Neurosurgical review · 2025Pooled it
- Ventricular Asystole During Le Fort I Orthognathic Surgery: A Case Consistent with Trigeminocardiac Reflex and a Mini Review.Clinics and practice · 2026Article
- Article
- Bradycardia and hypotension associated with trigeminocardiac reflex during orthognathic surgery: two case reports.Annals of medicine and surgery (2012) · 2025Article
- Trigeminocardiac reflex during bilateral sagittal split osteotomy.Journal of dental sciences · 2021Article
Corrections and comments
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Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Trigeminocardiac reflex (TCR) is a brainstem reflex triggered by the stimulation of any branch of the fifth cranial nerve along its course, presenting as a reduction in heart rate and blood pressure. Oculocardiac reflex is a well-known subtype of TCR. In the case reported here, remarkable arrhythmia followed by bradycardia occurred suddenly in a healthy patient undergoing orthognathic surgery. The heart rhythm recovered when the surgical manipulation ceased, but bradycardia was reproduced when the surgery resumed. This case of TCR is unique in that remarkable arrhythmia first appeared and led to bradycardia; accordingly, intravenous lidocaine and an anticholinergic agent were administered simultaneously instead of anticholinergic agents alone, and were protective. Although TCR rarely occurs during orthognathic surgery, clinicians should be aware of its possibility and able to judge and manage it promptly.
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Registered trials
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