Junctional rhythm with severe hypotension following infiltration of lidocaine containing epinephrine during dental surgery

We experienced an unusual case of accelerated junctional rhythm with severe hypotension after infiltration of lidocaine containing epinephrine during dental surgery under general anesthesia. The patient's electrocardiogram exhibited retrograde P-waves following the QRS complex, which could be m...

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Bibliographic Details
Published in:Journal of dental anesthesia and pain medicine: JDAPM 2020, 20(2), , pp.89-93
Main Authors: Jeon, Younghoon, Shim, Jihye, Kim, Hyunjee
Format: Article
Language:English
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Case Report
치의학
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Summary:We experienced an unusual case of accelerated junctional rhythm with severe hypotension after infiltration of lidocaine containing epinephrine during dental surgery under general anesthesia. The patient's electrocardiogram exhibited retrograde P-waves following the QRS complex, which could be misinterpreted as ST-segment depression. As a temporary measure, administration of ephedrine restored the patient's blood pressure to normal levels. The importance of this case lies in its demonstration of an unexpected and serious side effect of commonly used epinephrine infiltration. This case also highlights the need for accurate interpretation of the electrocardiogram and comprehensive understanding of best practices for patient management.
ISSN:2383-9309
2383-9317
DOI:10.17245/jdapm.2020.20.2.89