J Korean Assoc Oral Maxillofac Surg.  2021 Aug;47(4):335-336. 10.5125/jkaoms.2021.47.4.335.

Oculocardiac reflex: an unusual trigger during dental surgery

Affiliations
  • 1VA Puget Sound Health Care System, Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA, USA

Abstract

The oculocardiac reflex is a trigeminal-vagal reflex that manifests as cardiac arrythmias, most often bradycardia. The reflex can be triggered by manipulation of periorbital structures and unintended pressure on the bulbus oculi maxillofacial procedures. In this brief communication, we describe an unusual trigger of the oculocardiac reflex during maxillofacial surgery that resulted in severe bradycardia. This case highlights the need for careful securement of medical devices and attention to surgical technique to avoid undue pressure on draped fascial structures.

Keyword

Nasotracheal tube; Bradycardia; Oculocardiac reflex

Figure

  • Fig. 1 A. A folded surgical towel is placed on the forehead to support the Ring-Adair-Elwyn (RAE) tube. B. The folded towel is noted to have slipped (arrow) from under the RAE tube into the orbital cavity transmitting pressure from the surgeon’s hand above the drapes on to the globe.


Reference

References

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