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A Case of Wide QRS Tachycardia After the Local Administration of Epinephrine to Reduce Bleeding During General Anesthesia
We report a case of wide QRS tachycardia or ventricular tachycardia with a pulse after the administration of epinephrine under general anesthesia. After induction and achieving a sufficiently deep plane of general anesthesia, gauze soaked in a 1:100,000 epinephrine solution was applied to the patien...
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| Published in: | Anesthesia progress 2022-06, Vol.69 (2), p.38-40 |
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| Main Authors: | , , , , , , |
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| cites | cdi_FETCH-LOGICAL-c3075-5caf6f3839628e818e0e485d07356f135cae203d193d864f4a45b55d8d9404683 |
| container_end_page | 40 |
| container_issue | 2 |
| container_start_page | 38 |
| container_title | Anesthesia progress |
| container_volume | 69 |
| creator | Usami, Nayuka Tooyama, Midori Oda, Wakana Kawamoto, Yuu Kishimoto, Saki Minamide, Ayano Niwa, Hitoshi |
| description | We report a case of wide QRS tachycardia or ventricular tachycardia with a pulse after the administration of epinephrine under general anesthesia. After induction and achieving a sufficiently deep plane of general anesthesia, gauze soaked in a 1:100,000 epinephrine solution was applied to the patient's nasal mucosa and 1% lidocaine with 1:100,000 epinephrine was administered via intraoral infiltration. Several minutes after the start of surgery, the patient's blood pressure and heart rate suddenly increased and a wide QRS tachycardia was observed on the electrocardiogram, which then reverted to a normal sinus rhythm. According to the past reports, similar arrhythmias have occurred after administration of epinephrine in the head and neck. These findings suggest that anesthesia providers must be aware of the risks associated with epinephrine and local anesthetic use, particularly in the head and neck region. |
| doi_str_mv | 10.2344/anpr-68-03-05 |
| format | article |
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After induction and achieving a sufficiently deep plane of general anesthesia, gauze soaked in a 1:100,000 epinephrine solution was applied to the patient's nasal mucosa and 1% lidocaine with 1:100,000 epinephrine was administered via intraoral infiltration. Several minutes after the start of surgery, the patient's blood pressure and heart rate suddenly increased and a wide QRS tachycardia was observed on the electrocardiogram, which then reverted to a normal sinus rhythm. According to the past reports, similar arrhythmias have occurred after administration of epinephrine in the head and neck. 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These findings suggest that anesthesia providers must be aware of the risks associated with epinephrine and local anesthetic use, particularly in the head and neck region.</description><subject>Anesthesia</subject><subject>Anesthesiology</subject><subject>Angina pectoris</subject><subject>Blood pressure</subject><subject>Brief Communications from the Japanese Dental Society of Anesthesiology</subject><subject>Cardiac arrhythmia</subject><subject>Case reports</subject><subject>EKG</subject><subject>Electrocardiography</subject><subject>Epinephrine</subject><subject>Fentanyl</subject><subject>General anesthesia</subject><subject>Head and neck</subject><subject>Heart rate</subject><subject>Lidocaine</subject><subject>Patients</subject><subject>Surgery</subject><subject>Tachycardia</subject><subject>Ventricle</subject><issn>0003-3006</issn><issn>1878-7177</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNpVUU1r3DAQFaUl2aQ59i7o2enII8nypbDdpElhoTRN6VEo1jirsCu7kh3Yf1-ZhEIv82DexzwYxj4IuKxRyk8ujqnSpgKsQL1hK2EaUzWiad6yFUDZIoA-ZWc5PwEICbU8YaeojGwNtCt2XPONy8SHnv8OnviPu5_83nW7Y-eSD46v-4kSn3bEt0Pn9nztDyGGPCU3hSEutusxRBp3qUw-DfyO_NwR_7In8iE-8qs5LXBDkdLij5RLWg7uPXvXu32mi1c8Z7--Xt9vbqvt95tvm_W26hAaVanO9bpHg62uDRlhCEga5aFBpXuBhaca0IsWvdGyl06qB6W88a0EqQ2es88vueP8cCDfUSzl93ZM4eDS0Q4u2P-ZGHb2cXi2LYJQWJeAj68Bafgzl_r2aZhTLJ1trVuBgKpuiqp6UXVpyDlR_--CALt8yi6fstpYQAsK_wLLqYWf</recordid><startdate>20220601</startdate><enddate>20220601</enddate><creator>Usami, Nayuka</creator><creator>Tooyama, Midori</creator><creator>Oda, Wakana</creator><creator>Kawamoto, Yuu</creator><creator>Kishimoto, Saki</creator><creator>Minamide, Ayano</creator><creator>Niwa, Hitoshi</creator><general>Allen Press Inc</general><general>American Dental Society of Anesthisiology</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PADUT</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>5PM</scope></search><sort><creationdate>20220601</creationdate><title>A Case of Wide QRS Tachycardia After the Local Administration of Epinephrine to Reduce Bleeding During General Anesthesia</title><author>Usami, Nayuka ; 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| identifier | ISSN: 0003-3006 |
| ispartof | Anesthesia progress, 2022-06, Vol.69 (2), p.38-40 |
| issn | 0003-3006 1878-7177 |
| language | eng |
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| source | PubMed Central |
| subjects | Anesthesia Anesthesiology Angina pectoris Blood pressure Brief Communications from the Japanese Dental Society of Anesthesiology Cardiac arrhythmia Case reports EKG Electrocardiography Epinephrine Fentanyl General anesthesia Head and neck Heart rate Lidocaine Patients Surgery Tachycardia Ventricle |
| title | A Case of Wide QRS Tachycardia After the Local Administration of Epinephrine to Reduce Bleeding During General Anesthesia |
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