Paper Information

Journal:   JOURNAL OF RESEARCH IN DENTAL SCIENCES   SPRING 2008 , Volume 5 , Number 1; Page(s) 62 To 67.
 
Paper: 

EVALUATION OF TRIGEMINOCARDIAC REFLEX DURING MAXILLARY DOWN FRACTURE

 
 
Author(s):  BOHLOULI B., SARKARAT F., TAFAZZOLISHADPOUR H., MORADI B.
 
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Abstract: 

Background and Aim: According to the importance of trigemino cardiac reflex (TCR) and also prevention and management of this reflex in maxillofacial surgeries, the present study was held to evaluate the TCR In lefort I osteotomy. on patients who came to Surgical Department of Buali hospital and the private office in 1386-87.
Material and Method: The study was held on 30 patients at the age of 18-39 which were candidate for osteotomy lefort I surgery. TCR was defined as a drop in mean arterial blood pressure (MABP) and heart rate (HR) of more than 10% to the baseline values before maxillary down fracture (D.F) and coinciding with D.F. Hemodynamic parameters such as HR and MABP evaluated with continuous monitoring in different times (before, during and after down fracture of maxilla). Changes in upon characteristics were analyzed.
Results: 5 patients were excluded for different reasons and study was completed on 25 patients. Age of the patients was 24.6±1.6, 30% male, and 70% female. The mean HR fell 6.5% from a mean of 94.29±12.12 beats/min, before D.F to a mean of 88.08±13.6 beats/min during D.F, returning to a mean of 93.92±13.09 after D.F. The MABP fell 9.7% from to a mean of 103±15.89 mmHg before D.F to a mean of 92.99±15.19 during the D.F, returning to a mean of 99.69±13.123 after D.F. The HR and MABP after DF were not significantly different from baseline values before the DF. The mean HR drop of more than 10% to the baseline values before DF and coinciding with DF, in 25% of the patients, and also about the MABP, it fell in 45.8% of the patients.
Conclusions and suggestions: The present results give evidence that stimulation or manipulation of maxillary branch of the trigeminal nerve can cause TCR, leading to a significant decrease in HR and MABP under a standardized anesthetic protocol. Further studies preferably with a multicenter design are necessary to confirm the nature, description.

predisposing and triggering factors and other aspects of this seemingly physiologic phenomenon.
 
Keyword(s): TRIGEMINO CARDIAC REFLEX, LEFORT I OSTEOTOMY, MAXI11ARY DOWN FRACTURE
 
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