Academic Journal
Role of anesthetic techniques in trigeminocardiac reflex during oral surgery of the mandible under local anesthesia.
| Τίτλος: | Role of anesthetic techniques in trigeminocardiac reflex during oral surgery of the mandible under local anesthesia. |
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| Συγγραφείς: | Cavlı B; Asst. Professor, Oral and Maxillofacial Surgery Specialist, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Kutahya Health Science University, Kütahya, Turkey. Electronic address: bedreddincavli@gmail.com., Şaylığ A; Asst. Professor, Oral and Maxillofacial Surgery Specialist, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Kutahya Health Science University, Kütahya, Turkey. Electronic address: aykut.saylig@ksbu.edu.tr., Kale Ş; Oral and Maxillofacial Surgery Specialist, Kütahya Oral and Dental Health Hospital, Ministry of Health, Kütahya, Turkey. Electronic address: seyma.kale@ksbu.edu.tr., Şengel N; Asst. Professor, Anesthesiology and Reanimation Specialist, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gazi University, Ankara, Turkey. Electronic address: necmiyesengel@gazi.edu.tr., Yücel ZE; Professor, Oral and Maxillofacial Surgery Specialist, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul Uskudar University, İstanbul, Turkey. Electronic address: ergun.yucel@uskudar.edu.tr. |
| Πηγή: | Journal of stomatology, oral and maxillofacial surgery [J Stomatol Oral Maxillofac Surg] 2026 Jun; Vol. 127 (3), pp. 102704. Date of Electronic Publication: 2025 Dec 31. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier Masson SAS Country of Publication: France NLM ID: 101701089 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2468-7855 (Electronic) Linking ISSN: 24687855 NLM ISO Abbreviation: J Stomatol Oral Maxillofac Surg Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Issy les Moulineaux Cedex : Elsevier Masson SAS, [2017]- |
| Ιατρικοί όροι (MeSH): | Reflex, Trigeminocardiac*/drug effects , Reflex, Trigeminocardiac*/physiology , Anesthesia, Local*/methods , Anesthesia, Local*/adverse effects , Nerve Block*/methods , Nerve Block*/adverse effects , Mandible*/surgery , Tooth, Impacted*/surgery , Anesthesia, Dental*/methods , Oral Surgical Procedures*/methods, Mandibular Nerve/drug effects ; Heart Rate/drug effects ; Heart Rate/physiology ; Tooth Extraction/methods ; Bradycardia/etiology ; Humans ; Female ; Prospective Studies ; Adult ; Male ; Young Adult |
| Περίληψη: | İNTRODUCTION: The trigeminocardiac reflex is a clinically important autonomic response to trigeminal stimulation, particularly characterized by heart rate reduction; however, its behavior under local anesthesia is not well defined. This prospective clinical study investigated the impact of different local anesthesia techniques on the incidence and hemodynamic characteristics of the trigeminocardiac reflex (TCR) during mandibular nerve stimulation in awake patients. Materials and Methods: Forty individuals undergoing surgical extraction of impacted mandibular teeth were enrolled. To minimize vasovagal influence, anxious patients were excluded. Group-1 received a Gow-Gates mandibular nerve block, whereas Group-2 received an inferior alveolar nerve block with supplementary buccal anesthesia. Heart rate (HR) and mean arterial blood pressure (MABP) were continuously monitored throughout local anesthesia administration and all surgical stages. Results: TCR-compatible bradycardia occurred in 30% (12/40) of patients, most frequently during anesthetic injection and mucosal manipulation, including flap elevation, and suturing.A significantly higher incidence of the TCR was observed in Group 1.The maximum HR reduction recorded was 43.5%. The linear progression of stage-specific baseline MABP and HR values showed a significant decrease during curettage/irrigation and suturing. Conclusion: These findings demonstrate that the TCR can occur during oral surgery performed under local anesthesia, typically at mild levels, and that the anesthesia technique influences its incidence. This study contributes to the current literature by evaluating the prophylactic potential of different local anesthesia techniques in oral surgery and by integrating anxiety assessment to enhance methodological robustness. (Copyright © 2026 Elsevier Masson SAS. All rights reserved.) |
| Competing Interests: | Declaration of competing interest The authors declare that they have no competing interest. |
| Contributed Indexing: | Keywords: Gow-Gates; Inferior alveolar nerve block; Local anesthesia technique; Trigemino-vagal connection; Trigeminocardiac reflex |
| Entry Date(s): | Date Created: 20260102 Date Completed: 20260605 Latest Revision: 20260606 |
| Update Code: | 20260606 |
| DOI: | 10.1016/j.jormas.2025.102704 |
| PMID: | 41482065 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 2468-7855 |
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| DOI: | 10.1016/j.jormas.2025.102704 |