{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,12]],"date-time":"2026-11-12T00:37:23Z","timestamp":1794443843208,"version":"4.9.1"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,1,13]],"date-time":"2021-01-13T00:00:00Z","timestamp":1610496000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,1,13]],"date-time":"2021-01-13T00:00:00Z","timestamp":1610496000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Anesthesiol"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Trigeminal-cardiac reflex (TCR) is a brainstem vagus reflex that occurs when any center or peripheral branch of the trigeminal nerve was stimulated or operated on. The typical clinical manifestation is sudden bradycardia with or without blood pressure decline. The rhino-cardiac reflex which is one type of TCR is rare in clinical practice. As the rhino-cardiac reflex caused by disinfection of the nasal cavity is very rare, we report these two cases to remind other anesthesiologists to be vigilant to this situation.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>This case report describes two cases of cardiac arrest caused by rhino-cardiac reflex while disinfecting nasal cavity before endoscopic transsphenoidal removal of pituitary adenomas. Their heart rate all dropped suddenly at the very moment of nasal stimulation and recovered quickly after stimulation was stopped and the administration of drugs or cardiac support.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Although the occurrence of rhino-cardiac reflex is rare, we should pay attention to it in clinical anesthesia. It is necessary to know the risk factors for preventing it. Once it occurs, we should take active and effective rescue measures to avoid serious complications.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12871-021-01240-w","type":"journal-article","created":{"date-parts":[[2021,1,13]],"date-time":"2021-01-13T08:04:13Z","timestamp":1610525053000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Case report: 2 cases of cardiac arrest caused by rhino-cardiac reflex while disinfecting nasal cavity before endonasal transsphenoidal endoscopic pituitary surgery"],"prefix":"10.1186","volume":"21","author":[{"given":"Wen","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongwei","family":"Cai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiping","family":"Ding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3374-4420","authenticated-orcid":false,"given":"Xiaoping","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,1,13]]},"reference":[{"issue":"22","key":"1240_CR1","doi-asserted-by":"publisher","first-page":"78","DOI":"10.3760\/cma.j.issn.1673-4904.2013.22.032","volume":"36","author":"S Zhen","year":"2013","unstructured":"Zhen S, Hailin L. A case of severe rhino-cardiac reflex during anesthesia for transsphenoidal pituitary adenoma resection [J]. Chinese J Med Education. 2013;36(22):78. https:\/\/doi.org\/10.3760\/cma.j.issn.1673-4904.2013.22.032.","journal-title":"Chinese J Med Education"},{"issue":"1","key":"1240_CR2","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1586\/14779072.2014.862498","volume":"12","author":"T Chowdhury","year":"2014","unstructured":"Chowdhury T, Sandu N, Sadr-Eshkevari P, et al. Trigeminocardiac reflex: current trends. Expert Rev Cardiovasc Ther. 2014;12(1):9\u201311.","journal-title":"Expert Rev Cardiovasc Ther"},{"issue":"2","key":"1240_CR3","doi-asserted-by":"publisher","first-page":"215","DOI":"10.3171\/jns.1999.90.2.0215","volume":"90","author":"B Schaller","year":"1999","unstructured":"Schaller B, Probst R, Strebel S, et al. Trigeminocardiac reflex during surgery in the cerebellopontine angle. 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Hubei: Huazhong University of science and technology; 2019."},{"issue":"6","key":"1240_CR9","first-page":"45","volume":"32","author":"D Awasthi","year":"2015","unstructured":"Awasthi D, Roy TM, Byrd RP Jr. Epistaxis and death by the Trigeminocardiac reflex: a cautionary report. Fed Pract. 2015;32(6):45\u20139.","journal-title":"Fed Pract"},{"issue":"3","key":"1240_CR10","doi-asserted-by":"publisher","first-page":"348","DOI":"10.1001\/archopht.1957.00940010360005","volume":"58","author":"RE Kirsch","year":"1957","unstructured":"Kirsch RE, Samet P, Kugel V, et al. Electrocardiographic changes during ocular surgery and their prevention by retrobulbar injection. AMA Arch Ophthalmol. 1957;58(3):348\u201356.","journal-title":"AMA Arch Ophthalmol"},{"issue":"3","key":"1240_CR11","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1016\/j.ijom.2011.12.025","volume":"41","author":"E Yorgancilar","year":"2012","unstructured":"Yorgancilar E, Gun R, Yildirim M, et al. Determination of trigeminocardiac reflex during rhinoplasty. Int J Oral Maxillofac Surg. 2012;41(3):389\u201393.","journal-title":"Int J Oral Maxillofac Surg"},{"issue":"18","key":"1240_CR12","doi-asserted-by":"publisher","first-page":"E807","DOI":"10.1097\/MD.0000000000000807","volume":"94","author":"C Meuwly","year":"2015","unstructured":"Meuwly C, Chowdhury T, Sandu N, et al. Anesthetic influence on occurrence and treatment of the Trigemino-cardiac reflex a systematic literature review [J]. Medicine. 2015;94(18):E807\u201316.","journal-title":"Medicine."},{"issue":"1","key":"1240_CR13","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1186\/s12871-019-0712-z","volume":"19","author":"RW Arnold","year":"2019","unstructured":"Arnold RW, Bond AN, McCall M, Lunoe L. The oculocardiac reflex and depth of anesthesia measured by brain wave. BMC Anesthesiol. 2019;19(1):36. 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