聴神経腫瘍手術中に三叉神経心臓反射による心静止を来した1症例

Transient Asystole Caused by Trigeminocardiac Reflex during Surgery for Acoustic Neuroma：A Case Report

要旨

　今回，聴神経腫瘍に対しての術中に，三叉神経への直接刺激時に三叉神経心臓反射（trigeminocardiac reflex：TCR）が生じ，11秒間の心静止となった症例を経験した。手術の中断とアトロピン投与で心拍は再開した。TCRは三叉神経感覚枝が分布するすべての頭頸部手術で起こりうるため術者との連携，速やかな認識と対応が重要である。

　The trigeminnocardiac reflex（TCR）is a brainstem reflex defined as hypotension, bradycardia, and asystole that occurs upon stimulation of the sensory branches of the trigeminal nerve.

　We experienced a case of transient asystole due to TCR at the time of dissection of the tumor from the trigeminal nerve during surgery for acoustic neuroma. The heart rate returned in 11 seconds after the interruption of the surgical operation.

　Since TCR can occur in all head and neck surgeries, it is crucial to collaborate with the surgeon, manage anesthesia with TCR in mind, and respond promptly when it occurs.