Intra-Arterial Lidocaine Blunts the Trigeminocardiac Reflex during Endovascular Treatment of a Carotid-Cavernous Fistula

Table 1

Prevention and treatment of trigeminocardiac reflex.

---

Awareness of occurrence during high-risk surgery

Increasing the depth of anesthesia with intravenous or volatile agents before surgical stimulation

Prophylactic nerve blocks were appropriate

Gentle manipulation and traction around the nerve

Avoidance of hypoxia and hypercapnia

Close monitoring of heart rate and blood pressure

Cessation of stimulation if the reflex is triggered

Treatment with vagolytic agents (atropine or glycopyrrolate)

If unresponsive to vagolytic agents, epinephrine is administered

Prophylaxis or treatment with intravascular lidocaine through an indwelling catheter during endovascular procedures.

---