A rare event of trigeminocardiac reflex during mandibular branch of trigeminal nerve radiofrequency ablation

We at Our Pain Clinic witnessed a rare event of recurrent bradycardia and hypotension during radiofrequency ablation of mandibular division of trigeminal nerve. A 48-year-old lady with trigeminal neuralgia in left V3 distribution was posted for V3 division rhizotomy under fluoroscopy. The patient had transient episodes of bradycardia and hypotension during the procedure. The patient had transient episodes of bradycardia and hypotension during the procedure. HR and BP were reverted to baseline with injection atropine and intravenous fluids. This response is most likely attributed to trigemino cardiac reflex, which occurs due to inadvertent stimulation of trigeminal nerve.