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The Effect of Atropine on Trigeminocardiac Reflex-induced Hemodynamic Changes During Therapeutic Compression of the Trigeminal Ganglion.
J Neurosurg Anesthesiol. 2020 Jun 02 [Online ahead of print]JN

Abstract

BACKGROUND

Percutaneous compression of the trigeminal ganglion (PCTG) can induce significant hemodynamic perturbations secondary to the trigeminocardiac reflex (TCR). The aim of this study was to investigate the effect of atropine pretreatment on hemodynamic responses during PCTG for trigeminal neuralgia.

MATERIALS AND METHODS

A total of 120 patients who received PCTG were randomly assigned to control and atropine groups that were pretreated with saline (n=60) and atropine 0.004 mg/kg intravenously (n=60), respectively. Heart rate (HR) and mean arterial pressure (MAP) were measured at 9 timepoints from before induction of anesthesia until the end of the PCTG procedure; the incidence of TCR was also observed.

RESULTS

HR was higher in the atropine compared with control group from the time of skin puncture with the PCTG needle until after the procedure was completed (P<0.05). MAP was also higher in the atropine compared with control group, but only at entry of the needle into the foramen ovale until 1 minute after trigeminal ganglion compression (P<0.05). HR was reduced in both groups during entry of the needle into the foramen ovale and during ganglion compression, but less so in the atropine compared with the control group (P<0.05). MAP increased during PCTG compared with baseline in both groups, but with a larger increase in the atropine group (P<0.05). Two and 52 cases in the control group, and 6 and 1 cases in the atropine group, exhibited a TCR during entry of the needle into the foramen ovale and at ganglion compression, respectively (P<0.05).

CONCLUSION

Pretreatment with atropine was effective in most patients at minimizing abrupt reduction in HR during PCTG.

Authors+Show Affiliations

Department of Anaesthesiology, Shengjing Hospital of China Medical University. Department of Anesthesiology.Department of Anesthesiology, the General Hospital of Northern Theater Command, Shenyang, China.Department of Anaesthesiology, Shengjing Hospital of China Medical University.Second Department of Neurosurgery, People's Hospital of China Medical University (Liaoning Provical People's Hospital).Department of Anesthesiology.Second Department of Neurosurgery, People's Hospital of China Medical University (Liaoning Provical People's Hospital).Second Department of Neurosurgery, People's Hospital of China Medical University (Liaoning Provical People's Hospital).

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32496449

Citation

Wang, Chang-Ming, et al. "The Effect of Atropine On Trigeminocardiac Reflex-induced Hemodynamic Changes During Therapeutic Compression of the Trigeminal Ganglion." Journal of Neurosurgical Anesthesiology, 2020.
Wang CM, Guan ZY, Zhao P, et al. The Effect of Atropine on Trigeminocardiac Reflex-induced Hemodynamic Changes During Therapeutic Compression of the Trigeminal Ganglion. J Neurosurg Anesthesiol. 2020.
Wang, C. M., Guan, Z. Y., Zhao, P., Huang, H. T., Zhang, J., Li, Y. F., & Ma, Y. (2020). The Effect of Atropine on Trigeminocardiac Reflex-induced Hemodynamic Changes During Therapeutic Compression of the Trigeminal Ganglion. Journal of Neurosurgical Anesthesiology. https://doi.org/10.1097/ANA.0000000000000702
Wang CM, et al. The Effect of Atropine On Trigeminocardiac Reflex-induced Hemodynamic Changes During Therapeutic Compression of the Trigeminal Ganglion. J Neurosurg Anesthesiol. 2020 Jun 2; PubMed PMID: 32496449.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Effect of Atropine on Trigeminocardiac Reflex-induced Hemodynamic Changes During Therapeutic Compression of the Trigeminal Ganglion. AU - Wang,Chang-Ming, AU - Guan,Zhan-Ying, AU - Zhao,Ping, AU - Huang,Hai-Tao, AU - Zhang,Jing, AU - Li,Yan-Feng, AU - Ma,Yi, Y1 - 2020/06/02/ PY - 2020/6/5/entrez JF - Journal of neurosurgical anesthesiology JO - J Neurosurg Anesthesiol N2 - BACKGROUND: Percutaneous compression of the trigeminal ganglion (PCTG) can induce significant hemodynamic perturbations secondary to the trigeminocardiac reflex (TCR). The aim of this study was to investigate the effect of atropine pretreatment on hemodynamic responses during PCTG for trigeminal neuralgia. MATERIALS AND METHODS: A total of 120 patients who received PCTG were randomly assigned to control and atropine groups that were pretreated with saline (n=60) and atropine 0.004 mg/kg intravenously (n=60), respectively. Heart rate (HR) and mean arterial pressure (MAP) were measured at 9 timepoints from before induction of anesthesia until the end of the PCTG procedure; the incidence of TCR was also observed. RESULTS: HR was higher in the atropine compared with control group from the time of skin puncture with the PCTG needle until after the procedure was completed (P<0.05). MAP was also higher in the atropine compared with control group, but only at entry of the needle into the foramen ovale until 1 minute after trigeminal ganglion compression (P<0.05). HR was reduced in both groups during entry of the needle into the foramen ovale and during ganglion compression, but less so in the atropine compared with the control group (P<0.05). MAP increased during PCTG compared with baseline in both groups, but with a larger increase in the atropine group (P<0.05). Two and 52 cases in the control group, and 6 and 1 cases in the atropine group, exhibited a TCR during entry of the needle into the foramen ovale and at ganglion compression, respectively (P<0.05). CONCLUSION: Pretreatment with atropine was effective in most patients at minimizing abrupt reduction in HR during PCTG. SN - 1537-1921 UR - https://www.unboundmedicine.com/medline/citation/32496449/The_Effect_of_Atropine_on_Trigeminocardiac_Reflex-induced_Hemodynamic_Changes_During_Therapeutic_Compression_of_the_Trigeminal_Ganglion L2 - https://doi.org/10.1097/ANA.0000000000000702 DB - PRIME DP - Unbound Medicine ER -
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