Incidence of trigeminocardiac reflex in maxillofacial surgery: A retrospective study

Introduction: The trigeminocardiac reflex (TCR) is a brainstem reflex that has attracted the attention of many clinical researchers, including neurosurgeons, anaesthetists, ophthalmologists, and general, plastic, and craniomaxillofacial surgeons. However, more maxillofacial surgery studies related to TCR need to be conducted in order to better understand this phenomenon. Aim: The aim of this study was to evaluate the occurrence of TCR during maxillofacial procedures performed between 2008 and 2012 including trauma, orthognathic, and reconstructive surgeries. Additionally, with a literature review provide information regarding its incidence, predisposing factors and management. Subjects and Methods: A five-year retrospective study was conducted to evaluate the charts of 56 healthy patients (classified as American Society of Anaesthesiologists class I) admitted in the Department of Oral and Maxillofacial Surgery from 2008 through 2012 at King Abdulaziz Medical City (formerly known as King Khalid National Guard Hospital), Jeddah. Information regarding the different types of procedures and occurrence of TCR in each case was collected. SPSS (V 11.5) was used to analyse the data collected. Results: The overall incidence of TCR was 20% of all the cases, with the highest percentage occurring during mid face trauma repair followed by upper face reconstructive surgeries. Conclusions: TCR can be fatal and must be taken in consideration. All craniomaxillofacial surgeons are advised to follow guidelines for the management of TCR illustrated by Arasho et al. in 2009.