Trigeminal Nerve Cardiac Reflex During Resection of Cerebellopontine Angle Tumors and Postoperative Myocardial Injury

Study Overview
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Brief Summary
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Myocardial injury after noncardiac surgery is significantly related to postoperative 30-day mortality. Trigeminal cardiac reflex is one of the main causes of perioperative cardiac emergency. Therefore, the investigators' aim is to test the hypothesis that trigeminal cardiac reflex associates postoperative myocardial damage in participants undergoing cerebellopontine angle tumor surgery. The investigators will observe the association between trigeminal cardiac reflex and myocardial injury by measuring the concentration of plasma high sensitivity cardiac troponin (hs-cTnT) in participants after cerebellopontine angle tumor surgery.

Official Title
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Trigeminal Nerve Cardiac Reflex During Resection of Cerebellopontine Angle Tumors and Postoperative Myocardial Injury: a Prospective Cohort Study

Conditions
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Myocardial Injury, Trigeminal Cardiac Reflex

Intervention / Treatment
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* Other: Trigeminal cardiac reflex
* Other: Non-trigeminal cardiac reflex


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients undergoing elective cerebellopontine angle tumor surgery. Age ≥ 18 years old. ASA class I to III. All those who sign the informed consent form. Exclusion Criteria: Patients with severe heart disease (including patients with preoperative heart rate < 50 beats / min, severe arrhythmias, such as premature beats, paroxysmal supraventricular tachycardia, atrial flutter or fibrillation, patients with myocardial ischemia < 6 months, heart failure, myocarditis, pericarditis or cardiomyopathy). Patients unable to complete preoperative cardiac assessment. Patients with chronic kidney disease.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Postoperative myocardial injury<br> | Other: Trigeminal cardiac reflex<br>* Trigeminal cardiac reflex occurred during the cerebellopontine angle tumor surgery.<br>|
| Non postoperative myocardial injury<br> | Other: Non-trigeminal cardiac reflex<br>* No trigeminal cardiac reflex occurred during the cerebellopontine angle tumor surgery.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The incidence of postoperative myocardial injury | the elevation of plasma high sensitivity cardiac troponin I (hs-cTnI) caused by myocardial ischemia or injury (exclude other causes such as sepsis, pulmonary embolism, atrial fibrillation, etc). The blood samples before and within 24 hours after operation will be collected and measured by Roche's fourth generation hs-cTnI. It is commonly defined as an elevation as any value above the 99th percentile upper reference limit for each specific troponin I assay | Postoperative 1 day. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The duration time of trigeminal cardiac reflex during cerebellopontine angle tumor surgery. | The duration time of trigeminal cardiac reflex during cerebellopontine angle tumor surgery. | The whole cerebellopontine angle tumor surgery procedure. |