The protective role of lidocaine in surgeries involving trigeminal nerve manipulation: a meta-analysis of trigeminocardiac reflex prevention
<p dir="ltr">The trigeminocardiac reflex (TCR) is activated when the trigeminal nerve is manipulated through mechanical pressure, traction, or irritation. This leads to a rapid increase in parasympathetic activity, resulting in a decrease in heart rate (HR) and blood pressure, which...
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| مؤلفون آخرون: | , , , , , |
| منشور في: |
2025
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| _version_ | 1864513537546649600 |
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| author | Almonzer Al-Qiami (22393303) |
| author2 | Sarah Amro (18139724) Khalid Sarhan (17430897) Yusra Arafeh (22393306) Mina Milad (22393309) Islam Omar (16666686) Abdulqadir J. Nashwan (11659453) |
| author2_role | author author author author author author |
| author_facet | Almonzer Al-Qiami (22393303) Sarah Amro (18139724) Khalid Sarhan (17430897) Yusra Arafeh (22393306) Mina Milad (22393309) Islam Omar (16666686) Abdulqadir J. Nashwan (11659453) |
| author_role | author |
| dc.creator.none.fl_str_mv | Almonzer Al-Qiami (22393303) Sarah Amro (18139724) Khalid Sarhan (17430897) Yusra Arafeh (22393306) Mina Milad (22393309) Islam Omar (16666686) Abdulqadir J. Nashwan (11659453) |
| dc.date.none.fl_str_mv | 2025-03-20T09:00:00Z |
| dc.identifier.none.fl_str_mv | 10.1007/s10143-025-03449-6 |
| dc.relation.none.fl_str_mv | https://figshare.com/articles/journal_contribution/The_protective_role_of_lidocaine_in_surgeries_involving_trigeminal_nerve_manipulation_a_meta-analysis_of_trigeminocardiac_reflex_prevention/30306850 |
| dc.rights.none.fl_str_mv | CC BY 4.0 info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Biomedical and clinical sciences Clinical sciences Neurosciences Lidocaine Meta-analysis Trigeminocardiac reflex |
| dc.title.none.fl_str_mv | The protective role of lidocaine in surgeries involving trigeminal nerve manipulation: a meta-analysis of trigeminocardiac reflex prevention |
| dc.type.none.fl_str_mv | Text Journal contribution info:eu-repo/semantics/publishedVersion text contribution to journal |
| description | <p dir="ltr">The trigeminocardiac reflex (TCR) is activated when the trigeminal nerve is manipulated through mechanical pressure, traction, or irritation. This leads to a rapid increase in parasympathetic activity, resulting in a decrease in heart rate (HR) and blood pressure, which can potentially lead to bradycardia, and cardiac arrest, with a prevalence of 14.5% during neurointerventional procedures (8). The aim of this study was to assess the effect of lidocaine injection on preventing TCR during cranial surgeries. We conducted a comprehensive search of PubMed, Web of Science, and Cochrane CENTRAL electronic databases for clinical trials comparing the use of lidocaine versus placebo, or no intervention for TCR prevention during cranial surgeries up until 20 May 2024. Meta-analyses were performed using fixed-effects models, and heterogeneity was assessed using I-squared and Chi-square tests. A total of five studies involving 421 patients were included in this meta-analysis. The incidence of TCR was significantly lower in the lidocaine group compared to the control group, with a risk ratio of 0.05 (95% CI 0.01 to 0.37, <i>P</i> = 0.003). Additionally, the lidocaine group had a relatively small change in HR, with a mean difference of -10.56 (95% CI -13.30 to -7.83 beat per minute, <i>P</i> = 0.00001). No statistically significant difference in mean arterial pressure was observed between the two groups (MD -5.15, 95% CI [-10.38 to 0.08 mmHg], <i>P</i> = 0.09). Our results suggest that lidocaine may be effective in preventing TCR and stabilizing HR. The use of lidocaine could be considered a prophylactic measure during cranial surgeries. Further studies are needed to investigate the optimal dose and timing of lidocaine administration.</p><h2>Other Information</h2><p dir="ltr">Published in: Neurosurgical Review<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1007/s10143-025-03449-6" target="_blank">https://dx.doi.org/10.1007/s10143-025-03449-6</a></p> |
| eu_rights_str_mv | openAccess |
| id | Manara2_75e5c73519e3bf845801b1f494e47d96 |
| identifier_str_mv | 10.1007/s10143-025-03449-6 |
| network_acronym_str | Manara2 |
| network_name_str | Manara2 |
| oai_identifier_str | oai:figshare.com:article/30306850 |
| publishDate | 2025 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | CC BY 4.0 |
| spelling | The protective role of lidocaine in surgeries involving trigeminal nerve manipulation: a meta-analysis of trigeminocardiac reflex preventionAlmonzer Al-Qiami (22393303)Sarah Amro (18139724)Khalid Sarhan (17430897)Yusra Arafeh (22393306)Mina Milad (22393309)Islam Omar (16666686)Abdulqadir J. Nashwan (11659453)Biomedical and clinical sciencesClinical sciencesNeurosciencesLidocaineMeta-analysisTrigeminocardiac reflex<p dir="ltr">The trigeminocardiac reflex (TCR) is activated when the trigeminal nerve is manipulated through mechanical pressure, traction, or irritation. This leads to a rapid increase in parasympathetic activity, resulting in a decrease in heart rate (HR) and blood pressure, which can potentially lead to bradycardia, and cardiac arrest, with a prevalence of 14.5% during neurointerventional procedures (8). The aim of this study was to assess the effect of lidocaine injection on preventing TCR during cranial surgeries. We conducted a comprehensive search of PubMed, Web of Science, and Cochrane CENTRAL electronic databases for clinical trials comparing the use of lidocaine versus placebo, or no intervention for TCR prevention during cranial surgeries up until 20 May 2024. Meta-analyses were performed using fixed-effects models, and heterogeneity was assessed using I-squared and Chi-square tests. A total of five studies involving 421 patients were included in this meta-analysis. The incidence of TCR was significantly lower in the lidocaine group compared to the control group, with a risk ratio of 0.05 (95% CI 0.01 to 0.37, <i>P</i> = 0.003). Additionally, the lidocaine group had a relatively small change in HR, with a mean difference of -10.56 (95% CI -13.30 to -7.83 beat per minute, <i>P</i> = 0.00001). No statistically significant difference in mean arterial pressure was observed between the two groups (MD -5.15, 95% CI [-10.38 to 0.08 mmHg], <i>P</i> = 0.09). Our results suggest that lidocaine may be effective in preventing TCR and stabilizing HR. The use of lidocaine could be considered a prophylactic measure during cranial surgeries. Further studies are needed to investigate the optimal dose and timing of lidocaine administration.</p><h2>Other Information</h2><p dir="ltr">Published in: Neurosurgical Review<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1007/s10143-025-03449-6" target="_blank">https://dx.doi.org/10.1007/s10143-025-03449-6</a></p>2025-03-20T09:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1007/s10143-025-03449-6https://figshare.com/articles/journal_contribution/The_protective_role_of_lidocaine_in_surgeries_involving_trigeminal_nerve_manipulation_a_meta-analysis_of_trigeminocardiac_reflex_prevention/30306850CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/303068502025-03-20T09:00:00Z |
| spellingShingle | The protective role of lidocaine in surgeries involving trigeminal nerve manipulation: a meta-analysis of trigeminocardiac reflex prevention Almonzer Al-Qiami (22393303) Biomedical and clinical sciences Clinical sciences Neurosciences Lidocaine Meta-analysis Trigeminocardiac reflex |
| status_str | publishedVersion |
| title | The protective role of lidocaine in surgeries involving trigeminal nerve manipulation: a meta-analysis of trigeminocardiac reflex prevention |
| title_full | The protective role of lidocaine in surgeries involving trigeminal nerve manipulation: a meta-analysis of trigeminocardiac reflex prevention |
| title_fullStr | The protective role of lidocaine in surgeries involving trigeminal nerve manipulation: a meta-analysis of trigeminocardiac reflex prevention |
| title_full_unstemmed | The protective role of lidocaine in surgeries involving trigeminal nerve manipulation: a meta-analysis of trigeminocardiac reflex prevention |
| title_short | The protective role of lidocaine in surgeries involving trigeminal nerve manipulation: a meta-analysis of trigeminocardiac reflex prevention |
| title_sort | The protective role of lidocaine in surgeries involving trigeminal nerve manipulation: a meta-analysis of trigeminocardiac reflex prevention |
| topic | Biomedical and clinical sciences Clinical sciences Neurosciences Lidocaine Meta-analysis Trigeminocardiac reflex |