{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T04:16:01Z","timestamp":1728360961879},"reference-count":10,"publisher":"American Dental Society of Anesthesiology (ADSA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017]]},"abstract":"We report a case of junctional rhythm that occurred both preoperatively and later during a portion of general anesthesia. A 19-year-old woman was scheduled to undergo bilateral sagittal split ramus osteotomy after being diagnosed with a jaw deformity. Preoperative electrocardiography (ECG) revealed a junctional rhythm with a slow heart rate (HR). At 90 minutes after anesthesia induction, local anesthesia with 10 mL of 1% lidocaine and 1:100,000 adrenaline was administered. A junctional rhythm appeared 15 minutes after the local anesthesia. We believe that the atrioventricular nodal pacemaker cells accelerated because of the increased sympathetic activity due to the adrenaline. On the preoperative ECG, the junctional rhythm with slow HR appeared as an escaped beat caused by slowing of the primary pacemaker. Therefore, we think that the preoperative junctional rhythm and the junctional rhythm that appeared during general anesthesia were due to different causes. Understanding the cause of a junctional rhythm could lead to more appropriate treatment. We therefore believe that identifying the cause of the junctional rhythm is important in anesthetic management.<\/jats:p>","DOI":"10.2344\/anpr-64-03-08","type":"journal-article","created":{"date-parts":[[2017,8,31]],"date-time":"2017-08-31T19:10:39Z","timestamp":1504206639000},"page":"165-167","source":"Crossref","is-referenced-by-count":3,"title":["Junctional Rhythm Preoperatively and During General Anesthesia for Oral and Maxillofacial Surgery"],"prefix":"10.2344","volume":"64","author":[{"given":"Naotaka","family":"Kishimoto","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Osaka Dental University, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ikue","family":"Kinoshita","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Osaka Dental University, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshihiro","family":"Momota","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Osaka Dental University, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1191","reference":[{"key":"i0003-3006-64-3-165-b01","series-title":"Acta Anaesthesiol Scand","first-page":"404","article-title":"Severe hypotension during the development of low-nodal junctional rhythm","volume":"53","author":"Asakura \n Y,","year":"2009","unstructured":"Asakura \n Y, \n \n \n Mizuno \n T, \n \n \n Kandatsu \n N, \n \n \n Fujiwara \n Y, \n \n \n Akashi \n M, \n \n \n Komatsu \n T. \n \n \n Severe hypotension during the development of low-nodal junctional rhythm. Acta Anaesthesiol Scand. 2009;53:404\u2013405."},{"key":"i0003-3006-64-3-165-b02","series-title":"Acta Anaesthesiol Scand","first-page":"509","article-title":"A marked decrease in heart rate variability associated with junctional rhythm during anesthesia with sevoflurane and fentanyl","volume":"50","author":"Fujiwara \n Y,","year":"2006","unstructured":"Fujiwara \n Y, \n \n \n Asakura \n Y, \n \n \n Shibata \n Y, \n \n \n Nishiwaki \n K, \n \n \n Komatsu \n T. \n \n \n A marked decrease in heart rate variability associated with junctional rhythm during anesthesia with sevoflurane and fentanyl. Acta Anaesthesiol Scand. 2006;50:509\u2013511."},{"key":"i0003-3006-64-3-165-b03","series-title":"Miller's Anesthesia","first-page":"1357","article-title":"Electrocardiography","author":"Hillel \n Z,","year":"2010","unstructured":"Hillel \n Z, \n \n \n Landesberg \n G. \n \n \n Electrocardiography. In: Miller RD, ed. Miller's Anesthesia. 7th ed. Philadelphia, Pa: Churchill Livingstone;2010:1357\u20131386."},{"key":"i0003-3006-64-3-165-b04","series-title":"Anesthesiology","first-page":"261","article-title":"Junctional rhythm induced by halothane anesthesia: treatment with succinylcholine","volume":"37","author":"Galindo \n A,","year":"1972","unstructured":"Galindo \n A, \n \n \n Wyte \n SR, \n \n \n Wetherhold \n JW. \n \n \n Junctional rhythm induced by halothane anesthesia: treatment with succinylcholine. Anesthesiology. 1972;37:261\u2013262."},{"key":"i0003-3006-64-3-165-b05","series-title":"J Perinatol","first-page":"65","article-title":"Non-sinus bradyarrhythmias in very low birth weight infants","volume":"27","author":"Gamble \n YD,","year":"2007","unstructured":"Gamble \n YD, \n \n \n Lutin \n WP, \n \n \n Mathew \n OP. \n \n \n Non-sinus bradyarrhythmias in very low birth weight infants. J Perinatol. 2007;27:65\u201367."},{"key":"i0003-3006-64-3-165-b06","series-title":"Anesthesiology","first-page":"180","article-title":"Successful treatment of accelerated junctional rhythm with propranolol: possible role of sympathetic stimulation in the genesis of this rhythm disturbance","volume":"62","author":"Breslow \n MJ,","year":"1985","unstructured":"Breslow \n MJ, \n \n \n Evers \n AS, \n \n \n Lebowitz \n P. \n \n \n Successful treatment of accelerated junctional rhythm with propranolol: possible role of sympathetic stimulation in the genesis of this rhythm disturbance. Anesthesiology. 1985;62:180\u2013182."},{"key":"i0003-3006-64-3-165-b07","series-title":"Acta Anaesthesiol Scand","first-page":"928","article-title":"Two cases of atrioventricular junctional rhythm induced by administration of regional injection of epinephrine","volume":"48","author":"Kunimatsu \n T.","year":"2004","unstructured":"Kunimatsu \n T. \n \n \n Two cases of atrioventricular junctional rhythm induced by administration of regional injection of epinephrine. Acta Anaesthesiol Scand. 2004;48:928."},{"key":"i0003-3006-64-3-165-b08","series-title":"Advanced cardiovascular life support: provider manual","article-title":"American Heart Association","author":"Sinz \n E,","year":"2011","unstructured":"Sinz \n E, \n \n \n Navarro \n K; \n \n \n American Heart Association. Advanced cardiovascular life support: provider manual. Dallas, Tex: American Heart Association;2011."},{"key":"i0003-3006-64-3-165-b09","series-title":"J Jpn Soc Clin Anesth","first-page":"499","article-title":"Analysis of atrio-ventricular junctional rhythm during general anesthesia [in Japanese]","volume":"14","author":"Sumida \n M,","year":"1994","unstructured":"Sumida \n M, \n \n \n Isawa \n E. \n \n \n Analysis of atrio-ventricular junctional rhythm during general anesthesia [in Japanese]. J Jpn Soc Clin Anesth. 1994;14:499\u2013507."},{"key":"i0003-3006-64-3-165-b10","series-title":"JAMA","first-page":"389","article-title":"Atrioventricular junctional rhythm in patients receiving oral verapamil therapy","volume":"249","author":"Walker \n WS,","year":"1983","unstructured":"Walker \n WS, \n \n \n Winniford \n MD, \n \n \n Mauritson \n DR, \n \n \n Johnson \n SM, \n \n \n Hillis \n LD. \n \n \n Atrioventricular junctional rhythm in patients receiving oral verapamil therapy. JAMA. 1983;249:389\u2013390."}],"container-title":["Anesthesia Progress"],"original-title":[],"link":[{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/view\/journals\/anpr\/64\/3\/article-p165.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/meridian.allenpress.com\/anesthesia-progress\/article-pdf\/64\/3\/165\/2102171\/anpr-64-03-08.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/downloadpdf\/journals\/anpr\/64\/3\/article-p165.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/downloadpdf\/journals\/anpr\/64\/3\/article-p165.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,7]],"date-time":"2024-10-07T12:38:59Z","timestamp":1728304739000},"score":1,"resource":{"primary":{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/view\/journals\/anpr\/64\/3\/article-p165.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017]]},"references-count":10,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.2344\/anpr-64-03-08","relation":{},"ISSN":["0003-3006","1878-7177"],"issn-type":[{"type":"print","value":"0003-3006"},{"type":"electronic","value":"1878-7177"}],"subject":[],"published":{"date-parts":[[2017]]}}}