Definition and Diagnosis of the Trigeminocardiac Reflex: A Grounded Theory Approach for an Update
- PMID: 29085328
- PMCID: PMC5649131
- DOI: 10.3389/fneur.2017.00533
Definition and Diagnosis of the Trigeminocardiac Reflex: A Grounded Theory Approach for an Update
Abstract
Background: The trigeminocardiac reflex (TCR) is defined as sudden onset of parasympathetic dysrhythmias including hemodynamic irregularities, apnea, and gastric hypermotility during stimulation of sensory branches of the trigeminal nerve. Since the first description of the TCR in 1999, there is an ongoing discussion about a more emergent clinical definition. In this work, the author worked out an approach to such an improved definition.
Methods: In this study, a grounded theory approach was used. Literature about TCR was systematically identified through PubMed (MEDLINE), EMBASE (Ovid SP), and ISI Web of Sciences databases from 1/2005 until 8/2015. TCR was defined as a drop of heart rate (HR) below 60 bpm or 20% to the baseline. A grounded theory approach was used to analyze and interpret the data through a synthesis by the researcher's perspectives, values, and positions.
Results: Out of the included studies, the authors formed available data to an update of the understanding of changes in hemodynamic parameters (HR and blood pressure) in a TCR. According to this update, an HR deceleration should be a constant observation to identify a TCR episode while a drop in blood pressure should probably not being fixed to a certain percentage of decrease.
Conclusion: The here presented working definition improves our understanding of the TCR. It leads the way to a new understanding of the TCR for a proper clinical definition.
Keywords: oculocardiac; reflex; trigeminocardiac; trigeminocardiac reflex.
Comment in
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Asystole triggered by the trigeminocardiac reflex following posttetanic count stimulation of the facial nerve: A case report.Eur J Anaesthesiol. 2020 Mar;37(3):247-248. doi: 10.1097/EJA.0000000000001133. Eur J Anaesthesiol. 2020. PMID: 32028290 No abstract available.
References
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- Kratschmer F. Über Reflexe von der Nasenschleimhaut auf Atmung und Kreislauf. Sber Akad Wiss Wien (1870) 62:147–70.
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- Aschner B. Über einen bisher nicht beschriebenen Reflex vom Auge auf Kreislauf und Atmung: Verschwinden des radialis Pulses bei Druck auf das Auge. Wien (1908) 21:1529.
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