Bayard, Denise; Lersch, Friedrich; Ugen, Gesar; Schaller, Bernhard (2022). Atypical trigeminocardiac reflex during intranasal dexmedetomidine sedation of a 6-month-old premature baby. BMJ case reports, 15(5) BMJ Publishing Group 10.1136/bcr-2021-247292
Full text not available from this repository.The trigeminocardiac reflex (TCR) is an established brainstem reflex leading to parasympathetic dysrhythmias-including haemodynamic irregularities, apnoea and gastric hypermotility-during stimulation of any sensory branches of the trigeminal nerve. Most of the clinical knowledge about TCR was gathered from general anaesthesia observations, not from procedural sedation.We present a case of a 6-month-old premature baby experiencing the reflex twice under dexmedetomidine-propofol-sedation while undergoing ophthalmic and ear examination. This was interpreted as cross-over sensitisation between the facial and trigeminal cranial nerve (N V and N VII).The present case demonstrates that different TCR subtypes can occur during the same anaesthetic procedure. Triggering TCR seems to be based on several factors and not just on a single stimulus as often presumed. Therefore, for premature babies, there is a risk for TCR under procedural sedation, and we recommend using glycopyrrolate as preventive treatment.
Item Type: |
Journal Article (Further Contribution) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy |
UniBE Contributor: |
Bayard, Denise Sylvie, Lersch, Friedrich, Ugen, Gesar Vincent |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1757-790X |
Publisher: |
BMJ Publishing Group |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
01 Jun 2022 09:12 |
Last Modified: |
05 Dec 2022 16:20 |
Publisher DOI: |
10.1136/bcr-2021-247292 |
PubMed ID: |
35641083 |
Uncontrolled Keywords: |
Anaesthesia Paediatrics Unwanted effects / adverse reactions |
URI: |
https://boris.unibe.ch/id/eprint/170363 |
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