title: Trigemino-cardiac reflex: occurrence of asystole during trans-sphenoidal adenomectomy: a case report.
abstract: The trigemino-cardiac reflex has been reported to occur during various craniofacial surgeries or procedures including manipulation of the trigeminal ganglion, tumor resection in the cerebellopontine angle, various facial reconstructions and trans-sphenoidal adenomectomy. Regarding risk factors during trans-sphenoidal adenomectomy, invasiveness closely related to the size of tumor and the degree of manipulation of cavernous sinus wall have been reported. We report the case of a 40-year-old female patient who had a relatively small-sized (< 10 mm) pituitary adenoma. Repetitive asystoles occurred during microscopic trans-sphenoidal operation of the wall of the cavernous sinus, which strongly suggests the importance of careful manipulation of the cavernous sinus wall. In addition to reporting this rare complication of trans-sphenoidal adenomectomy, we reviewed its clinical management by performing a literature search.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Dankook University College of Medicine, Cheonan, Korea.
authors.forename: Dae Geun
authors.initials: DG
authors.lastname: Jeon
authors.affiliation: Department of Anesthesiology and Pain Medicine, Dankook University College of Medicine, Cheonan, Korea.
authors.forename: Bong Jin
authors.initials: BJ
authors.lastname: Kang
authors.affiliation: Department of Anesthesiology and Pain Medicine, Dankook University College of Medicine, Cheonan, Korea.
authors.forename: Tae Won
authors.initials: TW
authors.lastname: Hur
keywords: Asystole; Trans-sphenoidal adenomectomy; Trigemino-cardiac reflex