Trigemino-cardiac reflex during transsphenoidal surgery for pituitary adenomas: Methodological description of a prospective skull base study protocol
Abstract A systematic clinical neuroscience protocol is described for the use to examine the trigemino-cardiac reflex (TCR) response in humans. Target neurosurgical conditions are operations that require manipulations around the peripheral and central part of the trigeminal nerve and its branches, e...
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| Veröffentlicht in: | Brain research 2007-05, Vol.1149, p.69-75 |
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| description | Abstract A systematic clinical neuroscience protocol is described for the use to examine the trigemino-cardiac reflex (TCR) response in humans. Target neurosurgical conditions are operations that require manipulations around the peripheral and central part of the trigeminal nerve and its branches, e.g. the cerebellopontine angle or the sellar region. To assess the hemodynamic and cardiac responses of patients after TCR initiation, anesthetic monitoring has been applied. The TCR is defined as a drop of more than 20% of the heart rate and the mean arterial blood pressure compared with the baseline values before the stimulus and coinciding with the surgical manipulation at or around any branches of the trigeminal nerve. By help of illustrative cases, we present for the first time preliminary results regarding the differentiation of the TCR in a central and a peripheral induction during transsphenoidal surgery of pituitary adenomas. Based on these results, we can conclude that we have developed a battery of preoperative examination procedures based on event-related diagnostics that was useful to differentiate different subgroups of TCR during transsphenoidal surgery. The presented protocol can be performed directly pre-, intra- and postoperatively and applied for assessment of TCR even in patients with known risk factors. |
| doi_str_mv | 10.1016/j.brainres.2005.08.060 |
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Target neurosurgical conditions are operations that require manipulations around the peripheral and central part of the trigeminal nerve and its branches, e.g. the cerebellopontine angle or the sellar region. To assess the hemodynamic and cardiac responses of patients after TCR initiation, anesthetic monitoring has been applied. The TCR is defined as a drop of more than 20% of the heart rate and the mean arterial blood pressure compared with the baseline values before the stimulus and coinciding with the surgical manipulation at or around any branches of the trigeminal nerve. By help of illustrative cases, we present for the first time preliminary results regarding the differentiation of the TCR in a central and a peripheral induction during transsphenoidal surgery of pituitary adenomas. Based on these results, we can conclude that we have developed a battery of preoperative examination procedures based on event-related diagnostics that was useful to differentiate different subgroups of TCR during transsphenoidal surgery. The presented protocol can be performed directly pre-, intra- and postoperatively and applied for assessment of TCR even in patients with known risk factors.</description><identifier>ISSN: 0006-8993</identifier><identifier>EISSN: 1872-6240</identifier><identifier>DOI: 10.1016/j.brainres.2005.08.060</identifier><identifier>PMID: 17428450</identifier><identifier>CODEN: BRREAP</identifier><language>eng</language><publisher>London: Elsevier B.V</publisher><subject>Adenoma - surgery ; Adult ; Anti-Arrhythmia Agents - therapeutic use ; Atropine - therapeutic use ; Biological and medical sciences ; Blood Pressure - physiology ; Clinical Protocols ; Female ; Fundamental and applied biological sciences. Psychology ; Heart rate ; Heart Rate - physiology ; Humans ; Hypotension, Orthostatic - etiology ; Hypotension, Orthostatic - prevention & control ; Intraoperative Complications - prevention & control ; Mean arterial blood pressure ; Monitoring, Physiologic - methods ; Motor control and motor pathways. Reflexes. Control centers of vegetative functions. Vestibular system and equilibration ; Neurology ; Neurosurgical Procedures - adverse effects ; Neurosurgical Procedures - methods ; Pituitary adenoma ; Pituitary Neoplasms - surgery ; Prospective Studies ; Reflex - physiology ; Skull Base - surgery ; Sphenoid Sinus - surgery ; Syncope, Vasovagal - etiology ; Syncope, Vasovagal - prevention & control ; Tachycardia - etiology ; Tachycardia - prevention & control ; Transsphenoidal ; Trigeminal Nerve - physiopathology ; Trigeminal Nerve - surgery ; Trigemino-cardiac reflex ; Vertebrates: nervous system and sense organs</subject><ispartof>Brain research, 2007-05, Vol.1149, p.69-75</ispartof><rights>Elsevier B.V.</rights><rights>2007 Elsevier B.V.</rights><rights>2007 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c482t-c72072d973fc5f904fe289adeb31583949ec57ba6fad6b12d5afc0f14f5b9c193</citedby><cites>FETCH-LOGICAL-c482t-c72072d973fc5f904fe289adeb31583949ec57ba6fad6b12d5afc0f14f5b9c193</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0006899307000741$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18748541$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17428450$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schaller, B.J</creatorcontrib><creatorcontrib>Weigel, D</creatorcontrib><creatorcontrib>Filis, A</creatorcontrib><creatorcontrib>Buchfelder, M</creatorcontrib><title>Trigemino-cardiac reflex during transsphenoidal surgery for pituitary adenomas: Methodological description of a prospective skull base study protocol</title><title>Brain research</title><addtitle>Brain Res</addtitle><description>Abstract A systematic clinical neuroscience protocol is described for the use to examine the trigemino-cardiac reflex (TCR) response in humans. Target neurosurgical conditions are operations that require manipulations around the peripheral and central part of the trigeminal nerve and its branches, e.g. the cerebellopontine angle or the sellar region. To assess the hemodynamic and cardiac responses of patients after TCR initiation, anesthetic monitoring has been applied. The TCR is defined as a drop of more than 20% of the heart rate and the mean arterial blood pressure compared with the baseline values before the stimulus and coinciding with the surgical manipulation at or around any branches of the trigeminal nerve. By help of illustrative cases, we present for the first time preliminary results regarding the differentiation of the TCR in a central and a peripheral induction during transsphenoidal surgery of pituitary adenomas. Based on these results, we can conclude that we have developed a battery of preoperative examination procedures based on event-related diagnostics that was useful to differentiate different subgroups of TCR during transsphenoidal surgery. The presented protocol can be performed directly pre-, intra- and postoperatively and applied for assessment of TCR even in patients with known risk factors.</description><subject>Adenoma - surgery</subject><subject>Adult</subject><subject>Anti-Arrhythmia Agents - therapeutic use</subject><subject>Atropine - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Blood Pressure - physiology</subject><subject>Clinical Protocols</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Heart rate</subject><subject>Heart Rate - physiology</subject><subject>Humans</subject><subject>Hypotension, Orthostatic - etiology</subject><subject>Hypotension, Orthostatic - prevention & control</subject><subject>Intraoperative Complications - prevention & control</subject><subject>Mean arterial blood pressure</subject><subject>Monitoring, Physiologic - methods</subject><subject>Motor control and motor pathways. Reflexes. Control centers of vegetative functions. Vestibular system and equilibration</subject><subject>Neurology</subject><subject>Neurosurgical Procedures - adverse effects</subject><subject>Neurosurgical Procedures - methods</subject><subject>Pituitary adenoma</subject><subject>Pituitary Neoplasms - surgery</subject><subject>Prospective Studies</subject><subject>Reflex - physiology</subject><subject>Skull Base - surgery</subject><subject>Sphenoid Sinus - surgery</subject><subject>Syncope, Vasovagal - etiology</subject><subject>Syncope, Vasovagal - prevention & control</subject><subject>Tachycardia - etiology</subject><subject>Tachycardia - prevention & control</subject><subject>Transsphenoidal</subject><subject>Trigeminal Nerve - physiopathology</subject><subject>Trigeminal Nerve - surgery</subject><subject>Trigemino-cardiac reflex</subject><subject>Vertebrates: nervous system and sense organs</subject><issn>0006-8993</issn><issn>1872-6240</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFks9u1DAQxiMEokvhFSpf4JYwdhw74YCoKv5JRRwoZ8uxx1tvs3Gwk4p9EN4XR7uoEpeePNb8xjP-vimKCwoVBSre7qo-aj9GTBUDaCpoKxDwpNjQVrJSMA5Piw0AiLLtuvqseJHSLl_ruoPnxRmVnLW8gU3x5yb6Le79GEqjo_XakIhuwN_ELtGPWzJHPaY03eIYvNUDSUvcYjwQFyKZ_Lz4Weebtjm_1-kd-YbzbbBhCFtvMm4xmein2YeRBEc0mWJIE5rZ3yNJd8swkF6nHM6LPazJOZgwvCyeOT0kfHU6z4ufnz7eXH0pr79__np1eV0a3rK5NJKBZLaTtTON64A7ZG2XZ-lr2rR1xzs0jey1cNqKnjLbaGfAUe6avjO0q8-LN8d3c-NfC6ZZ7X0yOAx6xLAkJYHLWjDxKEg7IakAnkFxBE3-Z8pSqin6fZZIUVCrc2qn_jmnVucUtCo7lwsvTh2Wfo_2oexkVQZenwCdsrIu-2J8euBayduG08x9OHKYhbv3GFUyHkeD1sesu7LBPz7L-_-eMIMfVz_v8IBpF5Y4ZlsUVYkpUD_WPVvXDGSOZJ7hLyaU1GU</recordid><startdate>20070529</startdate><enddate>20070529</enddate><creator>Schaller, B.J</creator><creator>Weigel, D</creator><creator>Filis, A</creator><creator>Buchfelder, M</creator><general>Elsevier B.V</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7X8</scope></search><sort><creationdate>20070529</creationdate><title>Trigemino-cardiac reflex during transsphenoidal surgery for pituitary adenomas: Methodological description of a prospective skull base study protocol</title><author>Schaller, B.J ; Weigel, D ; Filis, A ; Buchfelder, M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c482t-c72072d973fc5f904fe289adeb31583949ec57ba6fad6b12d5afc0f14f5b9c193</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adenoma - surgery</topic><topic>Adult</topic><topic>Anti-Arrhythmia Agents - therapeutic use</topic><topic>Atropine - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Blood Pressure - physiology</topic><topic>Clinical Protocols</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Heart rate</topic><topic>Heart Rate - physiology</topic><topic>Humans</topic><topic>Hypotension, Orthostatic - etiology</topic><topic>Hypotension, Orthostatic - prevention & control</topic><topic>Intraoperative Complications - prevention & control</topic><topic>Mean arterial blood pressure</topic><topic>Monitoring, Physiologic - methods</topic><topic>Motor control and motor pathways. Reflexes. Control centers of vegetative functions. Vestibular system and equilibration</topic><topic>Neurology</topic><topic>Neurosurgical Procedures - adverse effects</topic><topic>Neurosurgical Procedures - methods</topic><topic>Pituitary adenoma</topic><topic>Pituitary Neoplasms - surgery</topic><topic>Prospective Studies</topic><topic>Reflex - physiology</topic><topic>Skull Base - surgery</topic><topic>Sphenoid Sinus - surgery</topic><topic>Syncope, Vasovagal - etiology</topic><topic>Syncope, Vasovagal - prevention & control</topic><topic>Tachycardia - etiology</topic><topic>Tachycardia - prevention & control</topic><topic>Transsphenoidal</topic><topic>Trigeminal Nerve - physiopathology</topic><topic>Trigeminal Nerve - surgery</topic><topic>Trigemino-cardiac reflex</topic><topic>Vertebrates: nervous system and sense organs</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schaller, B.J</creatorcontrib><creatorcontrib>Weigel, D</creatorcontrib><creatorcontrib>Filis, A</creatorcontrib><creatorcontrib>Buchfelder, M</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Brain research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schaller, B.J</au><au>Weigel, D</au><au>Filis, A</au><au>Buchfelder, M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Trigemino-cardiac reflex during transsphenoidal surgery for pituitary adenomas: Methodological description of a prospective skull base study protocol</atitle><jtitle>Brain research</jtitle><addtitle>Brain Res</addtitle><date>2007-05-29</date><risdate>2007</risdate><volume>1149</volume><spage>69</spage><epage>75</epage><pages>69-75</pages><issn>0006-8993</issn><eissn>1872-6240</eissn><coden>BRREAP</coden><abstract>Abstract A systematic clinical neuroscience protocol is described for the use to examine the trigemino-cardiac reflex (TCR) response in humans. Target neurosurgical conditions are operations that require manipulations around the peripheral and central part of the trigeminal nerve and its branches, e.g. the cerebellopontine angle or the sellar region. To assess the hemodynamic and cardiac responses of patients after TCR initiation, anesthetic monitoring has been applied. The TCR is defined as a drop of more than 20% of the heart rate and the mean arterial blood pressure compared with the baseline values before the stimulus and coinciding with the surgical manipulation at or around any branches of the trigeminal nerve. By help of illustrative cases, we present for the first time preliminary results regarding the differentiation of the TCR in a central and a peripheral induction during transsphenoidal surgery of pituitary adenomas. Based on these results, we can conclude that we have developed a battery of preoperative examination procedures based on event-related diagnostics that was useful to differentiate different subgroups of TCR during transsphenoidal surgery. The presented protocol can be performed directly pre-, intra- and postoperatively and applied for assessment of TCR even in patients with known risk factors.</abstract><cop>London</cop><cop>Amsterdam</cop><cop>New York, NY</cop><pub>Elsevier B.V</pub><pmid>17428450</pmid><doi>10.1016/j.brainres.2005.08.060</doi><tpages>7</tpages></addata></record> |
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| ispartof | Brain research, 2007-05, Vol.1149, p.69-75 |
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| subjects | Adenoma - surgery Adult Anti-Arrhythmia Agents - therapeutic use Atropine - therapeutic use Biological and medical sciences Blood Pressure - physiology Clinical Protocols Female Fundamental and applied biological sciences. Psychology Heart rate Heart Rate - physiology Humans Hypotension, Orthostatic - etiology Hypotension, Orthostatic - prevention & control Intraoperative Complications - prevention & control Mean arterial blood pressure Monitoring, Physiologic - methods Motor control and motor pathways. Reflexes. Control centers of vegetative functions. Vestibular system and equilibration Neurology Neurosurgical Procedures - adverse effects Neurosurgical Procedures - methods Pituitary adenoma Pituitary Neoplasms - surgery Prospective Studies Reflex - physiology Skull Base - surgery Sphenoid Sinus - surgery Syncope, Vasovagal - etiology Syncope, Vasovagal - prevention & control Tachycardia - etiology Tachycardia - prevention & control Transsphenoidal Trigeminal Nerve - physiopathology Trigeminal Nerve - surgery Trigemino-cardiac reflex Vertebrates: nervous system and sense organs |
| title | Trigemino-cardiac reflex during transsphenoidal surgery for pituitary adenomas: Methodological description of a prospective skull base study protocol |
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