ArticleBMC anesthesiology2021
Case report: 2 cases of cardiac arrest caused by rhino-cardiac reflex while disinfecting nasal cavity before endonasal transsphenoidal endoscopic pituitary surgery.
Article in BMC anesthesiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled 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
- Exploring the trigeminocardiac reflex: an integrated view from mechanism to clinic.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2025Review
- Sewing: A New Quilting Suture Method for Nasal Septum Repair.The Journal of craniofacial surgery · 2024Article
- Neurally Mediated Syncope Triggered by COVID-19 Nasopharyngeal Swab Specimen Collection: A Case Report.Allergy & rhinology (Providence, R.I.)Article
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Authors and funding
4 authors.
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Abstract
backgroundTrigeminal-cardiac reflex (TCR) is a brainstem vagus reflex that occurs when any center or peripheral branch of the trigeminal nerve was stimulated or operated on. The typical clinical manifestation is sudden bradycardia with or without blood pressure decline. The rhino-cardiac reflex which is one type of TCR is rare in clinical practice. As the rhino-cardiac reflex caused by disinfection of the nasal cavity is very rare, we report these two cases to remind other anesthesiologists to be vigilant to this situation. CASE PRESENTATION: This case report describes two cases of cardiac arrest caused by rhino-cardiac reflex while disinfecting nasal cavity before endoscopic transsphenoidal removal of pituitary adenomas. Their heart rate all dropped suddenly at the very moment of nasal stimulation and recovered quickly after stimulation was stopped and the administration of drugs or cardiac support.
conclusionAlthough the occurrence of rhino-cardiac reflex is rare, we should pay attention to it in clinical anesthesia. It is necessary to know the risk factors for preventing it. Once it occurs, we should take active and effective rescue measures to avoid serious complications.
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