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Objective <p>The trigemino-cardiac reflex (TCR) is a brainstem reflex associated with adverse cardiovascular and respiratory responses. Recent studies have linked TCR with oral surgical procedures, including surgeries for Oral Submucous Fibrosis (OSF). This study aimed to assess the incidence of TCR during intraoperative mouth opening in OSF patients undergoing surgical management under local and general anesthesia.</p> Methods <p>Clinically diagnosed Grade III and IV OSF patients were included in the study. Variables including age, gender, pulse rate (PR), mean arterial blood pressure (MABP), and oxygen saturation (SpO₂) were recorded at baseline and during intraoperative mouth opening using a Heister jaw stretcher. Outcomes were compared between the local anesthesia (LA) and general anesthesia (GA) groups.</p> Results <p>Seventy patients were included, and bradycardia was observed more frequently in the 30–50-year age group (40.70%) than in the 20–30-year age group (31.30%). Under GA, 50% of patients experienced bradycardia, whereas only 24.10% developed bradycardia under LA. The incidence of bradycardia was significantly higher under GA compared to LA (<i>p</i> = 0.03). No major complications or asystole were observed.</p> Conclusion <p>TCR may occur during intraoperative mouth opening in OSF surgery, particularly under general anesthesia. Awareness of this reflex and its prompt management are essential to improve intraoperative patient safety.</p>

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Induction of Trigemino-Cardiac Reflex During Forceful Mouth Opening in Severe Oral Submucous Fibrosis

  • 期刊论文

  • 发表日期：

    2026年8月3日

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  • Deepika Jain,
  • Geeta Singh,
  • Sharon John,
  • Ravi Katrolia,
  • Nirmal Chaurasia,
  • Rangeet Bhadra

摘要

Objective

The trigemino-cardiac reflex (TCR) is a brainstem reflex associated with adverse cardiovascular and respiratory responses. Recent studies have linked TCR with oral surgical procedures, including surgeries for Oral Submucous Fibrosis (OSF). This study aimed to assess the incidence of TCR during intraoperative mouth opening in OSF patients undergoing surgical management under local and general anesthesia.

Methods

Clinically diagnosed Grade III and IV OSF patients were included in the study. Variables including age, gender, pulse rate (PR), mean arterial blood pressure (MABP), and oxygen saturation (SpO₂) were recorded at baseline and during intraoperative mouth opening using a Heister jaw stretcher. Outcomes were compared between the local anesthesia (LA) and general anesthesia (GA) groups.

Results

Seventy patients were included, and bradycardia was observed more frequently in the 30–50-year age group (40.70%) than in the 20–30-year age group (31.30%). Under GA, 50% of patients experienced bradycardia, whereas only 24.10% developed bradycardia under LA. The incidence of bradycardia was significantly higher under GA compared to LA (p = 0.03). No major complications or asystole were observed.

Conclusion

TCR may occur during intraoperative mouth opening in OSF surgery, particularly under general anesthesia. Awareness of this reflex and its prompt management are essential to improve intraoperative patient safety.