title: Comparative Study of Atropine Combined with Sodium Nitroprusside Pretreatment to Prevent Trigemino Cardiac Reflex after Trigeminal Ganglion Compression.
abstract: BACKGROUND
  Manipulation of percutaneous compression of the trigeminal ganglion (PCTG) for trigeminal neuralgia (TN) can lead to significant haemodynamic changes, which were termed trigemino cardiac reflex (TCR). Nevertheless, many studies indicated that atropine pretreatment can reduce the incidence of bradycardia and cardiac arrest, but do not take precautions against abrupt rise of blood pressure.
  
  
  OBJECTIVE
  The purpose of our study was to compare control group {patients receiving Sodium Nitro-Prusside (SNP) pretreatment before PCTG} with study groups (patients receiving different doses of atropine combined with SNP pretreatment before PCTG) in cardiovascular parameters {Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and Heart Rate (HR)} at 5 periods during Total Intravenous Anaesthesia (TIVA).
  
  
  METHODS
  In total, 120 patients, who underwent PTCG, were enrolled and randomly assigned into control group {group A (SNP pretreatment before PCTG, n=29)} and study groups {group B (0.002mg /kg atropine combined with SNP pretreatment before PCTG, n=30), C (0.004mg/kg atropine pretreatment before PCTG, n=31) and D (0.006mg/kg atropine combined with SNP pretreatment before PCTG, n=30)}, the relationship between haemodynamic changes and using atropine pretreatment or not was compared. Cardiovascular parameters were measured at five periods: preoperative (T0); before puncture (T1); during compression (T2); 1 min after the compression ended (T3); and 1 min after the procedure ended (T4). Multivariate analysis of variance (MANOVA) and Pearson's χ(2) test were used, and a value of p < 0.05 was considered statistically significant.
  
  
  RESULTS
  Compared with the group A, means of SBP and DBP in the study groups (group B, C and D) were not observed significant differences at all time points (p>0.05), the mean values of HR showed significant differences, when compared to group C and group D at T2 and T3 (p<0.001). Meanwhile, means of SBP, DBP and HR comparison in the same group were observed between T1 and T2, to the group A, B and D, means of HR (p>0.05 vs. T1) indicated significant differences, however, there was no significant difference in group C (p>0.05). Furthermore, the incidence of post-compression tachycardia was observed in each group.
  
  
  CONCLUSIONS
  By comparison, it seemed that 0.004mg/kg atropine pretreatment before PCTG was more reasonable for preventing significant haemodynamic changes.
authors.affiliation: Department of Anesthesiology, Liao Ning Provincial People's Hospital , Shen Yang, China .
authors.forename: Chang-Ming
authors.initials: CM
authors.lastname: Wang
authors.affiliation: Department of Anesthesiology, Branch Hospital of Hunnan, The General, Hospital of Shen Yang Military Region , Shen Yang, China .
authors.forename: Zhan-Ying
authors.initials: ZY
authors.lastname: Guan
authors.affiliation: Department of Anesthesiology, Liao Ning Provincial People's Hospital , Shen Yang, China .
authors.forename: Chang-Hua
authors.initials: CH
authors.lastname: Cai
authors.affiliation: Department of Anesthesiology, Liao Ning Provincial People's Hospital , Shen Yang, China .
authors.forename: Jing
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Anesthesiology, Liao Ning Provincial People's Hospital , Shen Yang, China .
authors.forename: Rong-Wei
authors.initials: RW
authors.lastname: Wang
authors.affiliation: Department of Anesthesiology, Liao Ning Provincial People's Hospital , Shen Yang, China .
authors.forename: Qing-Gui
authors.initials: QG
authors.lastname: Pang
authors.affiliation: Department of Anesthesiology, Liao Ning Provincial People's Hospital , Shen Yang, China .
authors.forename: Hui
authors.initials: H
authors.lastname: Liu
keywords: Haemodynamic changes; Percutaneous compression; Trigeminal neuralgia