Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2019 Apr 1;12(7):249-251.
doi: 10.1213/XAA.0000000000000979.

Asystole in Orthognathic Surgery: A Case Report

Stamatis Baronos  1 , Wayne Fong  1 , Nicholas P Saggese  2 , Jonathan Luke  3 , Khaja Ahmed  1 , Joel Yarmush  1
Affiliations
Case Reports

Asystole in Orthognathic Surgery: A Case Report

Stamatis Baronos et al. A A Pract. .

Abstract

A previously healthy 26-year-old man presented for elective Le Fort I osteotomy, bilateral mandibular osteotomy, and genioplasty. During the intraoperative course, the patient developed sudden bradycardia and asystole on placement of a bite block. Asystole is an extremely rare consequence of the trigeminocardiac reflex, and awareness of this potentially life-threatening complication is pivotal in its management.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure.
Figure.
The trigeminocardiac reflex arc via the mandibular branch of the trigeminal nerve secondary to placement of a bite block. If the condyle or osteotomy sites are malpositioned, maximum jaw opening can potentially stimulate either the inferior alveolar nerve or auriculotemporal nerve. Adapted from Singh et al, 2017.
See this image and copyright information in PMC

References

    1. Singh GP, Chowdhury T. Brain and heart connections: the trigeminocardiac reflex! J Neuroanaesthesiol Crit Care. 2017;4:71–77.
    1. Schaller B, Cornelius JF, Prabhakar H, et al. ; Trigemino-Cardiac Reflex Examination Group (TCREG). The trigemino-cardiac reflex: an update of the current knowledge. J Neurosurg Anesthesiol. 2009;21:187–195. - PubMed
    1. Shelly MP, Church JJ. Bradycardia and facial surgery. Anaesthesia. 1988;43:422–422. - PubMed
    1. Meuwly C, Chowdhury T, Sandu N, Reck M, Erne P, Schaller B. Anesthetic influence on occurrence and treatment of the trigemino-cardiac reflex: a systematic literature review. Medicine (Baltimore). 2015;94:e807. - PMC - PubMed
    1. Chowdhury T, Mendelowith D, Golanov E, et al. ; Trigemino-Cardiac Reflex Examination Group. Trigeminocardiac reflex: the current clinical and physiological knowledge. J Neurosurg Anesthesiol. 2015;27:136–147. - PubMed

Publication types

MeSH terms