Intra-Arterial Lidocaine Blunts the Trigeminocardiac Reflex during Endovascular Treatment of a Carotid-Cavernous Fistula

Intra-Arterial Lidocaine Blunts the Trigeminocardiac Reflex during Endovascular Treatment of a Carotid-Cavernous Fistula

Carotid-cavernous fistulas (CCFs) are vascular shunts that allow blood to flow from the carotid artery or its branches into the cavernous sinus. Endovascular embolization is the treatment modality of choice. The trigeminocardiac reflex (TCR) is a vagally mediated reflex that can lead to hemodynamic...

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Main Authors: Renee L. Coleman, Dmitri Bezinover, Douglas C. Jones, Kevin M. Cockroft, Uma R. Parekh
Format: Article
Language:English
Published: Hindawi Limited 2021-01-01
Series:Case Reports in Anesthesiology
Online Access:http://dx.doi.org/10.1155/2021/2342347
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spelling doaj-5727b1af64d0459f9aea0d82d382ccfc2021-02-15T12:52:57ZengHindawi LimitedCase Reports in Anesthesiology2090-63822090-63902021-01-01202110.1155/2021/23423472342347Intra-Arterial Lidocaine Blunts the Trigeminocardiac Reflex during Endovascular Treatment of a Carotid-Cavernous FistulaRenee L. Coleman0Dmitri Bezinover1Douglas C. Jones2Kevin M. Cockroft3Uma R. Parekh4Penn State Milton S. Hershey Medical Center, Department of Anesthesiology & Perioperative Medicine, Hershey, PA, USAPenn State Milton S. Hershey Medical Center, Department of Anesthesiology & Perioperative Medicine, Hershey, PA, USAPenn State Milton S. Hershey Medical Center, Department of Anesthesiology & Perioperative Medicine, Hershey, PA, USAPenn State Milton S. Hershey Medical Center, Department of Neurosurgery, Hershey, PA, USAPenn State Milton S. Hershey Medical Center, Department of Anesthesiology & Perioperative Medicine, Hershey, PA, USACarotid-cavernous fistulas (CCFs) are vascular shunts that allow blood to flow from the carotid artery or its branches into the cavernous sinus. Endovascular embolization is the treatment modality of choice. The trigeminocardiac reflex (TCR) is a vagally mediated reflex that can lead to hemodynamic instability. It can be activated during embolization procedures due to the proximity of vagal efferent neurovascular structures within the cavernous sinus. This case report describes the intraoperative management of recurrent, profound bradycardia due to TCR during endovascular CCF embolization.http://dx.doi.org/10.1155/2021/2342347
collection DOAJ
language English
format Article
sources DOAJ
author Renee L. Coleman
Dmitri Bezinover
Douglas C. Jones
Kevin M. Cockroft
Uma R. Parekh
spellingShingle Renee L. Coleman
Dmitri Bezinover
Douglas C. Jones
Kevin M. Cockroft
Uma R. Parekh
Intra-Arterial Lidocaine Blunts the Trigeminocardiac Reflex during Endovascular Treatment of a Carotid-Cavernous Fistula
Case Reports in Anesthesiology
author_facet Renee L. Coleman
Dmitri Bezinover
Douglas C. Jones
Kevin M. Cockroft
Uma R. Parekh
author_sort Renee L. Coleman
title Intra-Arterial Lidocaine Blunts the Trigeminocardiac Reflex during Endovascular Treatment of a Carotid-Cavernous Fistula
title_short Intra-Arterial Lidocaine Blunts the Trigeminocardiac Reflex during Endovascular Treatment of a Carotid-Cavernous Fistula
title_full Intra-Arterial Lidocaine Blunts the Trigeminocardiac Reflex during Endovascular Treatment of a Carotid-Cavernous Fistula
title_fullStr Intra-Arterial Lidocaine Blunts the Trigeminocardiac Reflex during Endovascular Treatment of a Carotid-Cavernous Fistula
title_full_unstemmed Intra-Arterial Lidocaine Blunts the Trigeminocardiac Reflex during Endovascular Treatment of a Carotid-Cavernous Fistula
title_sort intra-arterial lidocaine blunts the trigeminocardiac reflex during endovascular treatment of a carotid-cavernous fistula
publisher Hindawi Limited
series Case Reports in Anesthesiology
issn 2090-6382
2090-6390
publishDate 2021-01-01
description Carotid-cavernous fistulas (CCFs) are vascular shunts that allow blood to flow from the carotid artery or its branches into the cavernous sinus. Endovascular embolization is the treatment modality of choice. The trigeminocardiac reflex (TCR) is a vagally mediated reflex that can lead to hemodynamic instability. It can be activated during embolization procedures due to the proximity of vagal efferent neurovascular structures within the cavernous sinus. This case report describes the intraoperative management of recurrent, profound bradycardia due to TCR during endovascular CCF embolization.
url http://dx.doi.org/10.1155/2021/2342347
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