{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T01:05:06Z","timestamp":1772759106150,"version":"3.50.1"},"reference-count":7,"publisher":"American Dental Society of Anesthesiology (ADSA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018]]},"abstract":"A 23-year-old healthy man was scheduled for extraction of his mandibular third molars under general anesthesia with nasotracheal intubation. Sudden sinus tachycardia up to 170 beats\/min occurred when applying an epinephrine solution-soaked swab into the nasal cavity for preventing epistaxis during intubation. This was presumably evoked by submucosal migration of the swab into a false passage created because of the force applied during a prior failed attempt at nasal passage of the tracheal tube, and rapid epinephrine absorption by the traumatized mucosa. The causes of the unexpected severe tachycardia in our patient are discussed.<\/jats:p>","DOI":"10.2344\/anpr-66-01-02","type":"journal-article","created":{"date-parts":[[2019,1,4]],"date-time":"2019-01-04T01:13:09Z","timestamp":1546564389000},"page":"259-260","source":"Crossref","is-referenced-by-count":5,"title":["Sudden Tachycardia Due to Submucosal Migration of an Epinephrine-Soaked Swab During Nasal Intubation"],"prefix":"10.2344","volume":"65","author":[{"given":"Tsuyoshi","family":"Hoshi","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Showa University Koto Toyosu Hospital, Tokyo, Japan"},{"name":"Division of Anesthesiology, Department of Perioperative Medicine, Showa University School of Dentistry, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Showa University Koto Toyosu Hospital, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masayuki","family":"Somei","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Showa University Koto Toyosu Hospital, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takehiko","family":"Iijima","sequence":"additional","affiliation":[{"name":"Division of Anesthesiology, Department of Perioperative Medicine, Showa University School of Dentistry, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuka","family":"Kurihara","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Showa University Koto Toyosu Hospital, Tokyo, Japan"},{"name":"Division of Anesthesiology, Department of Perioperative Medicine, Showa University School of Dentistry, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1191","reference":[{"key":"i0003-3006-65-4-259-b01","series-title":"J Maxillofac Oral Surg","first-page":"366","article-title":"Nasotracheal intubation: an overview","volume":"13","author":"Prasanna \n D,","year":"2014","unstructured":"Prasanna \n D, \n \n \n Bhat \n S. \n \n \n Nasotracheal intubation: an overview. 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J Clin Anesth. 1990;2:16\u201320."},{"key":"i0003-3006-65-4-259-b03","series-title":"J Oral Maxillofac Surg","first-page":"2226","article-title":"Effects of nasal application of an epinephrine and lidocaine mixture on the hemodynamics and nasal mucosa in oral and maxillofacial surgery","volume":"66","author":"Kameyama \n K,","year":"2008","unstructured":"Kameyama \n K, \n \n \n Watanabe \n S, \n \n \n Kano \n T, \n \n \n Kusukawa \n J. \n \n \n Effects of nasal application of an epinephrine and lidocaine mixture on the hemodynamics and nasal mucosa in oral and maxillofacial surgery. J Oral Maxillofac Surg. 2008;66:2226\u20132232."},{"key":"i0003-3006-65-4-259-b04","series-title":"Drugs","first-page":"959","article-title":"Landiolol: a review of its use in intraoperative and postoperative tachyarrhythmias","volume":"73","author":"Plosker \n GL.","year":"2013","unstructured":"Plosker \n GL. \n \n \n Landiolol: a review of its use in intraoperative and postoperative tachyarrhythmias. 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Anaesthesia. 2014;69:591\u2013597."},{"key":"i0003-3006-65-4-259-b07","series-title":"Anesth Prog","first-page":"122","article-title":"Alternative methods for nasotracheal intubation and extubation in a patient with Apert syndrome","volume":"62","author":"Tsukamoto \n M,","year":"2015","unstructured":"Tsukamoto \n M, \n \n \n Yokoyama \n T. \n \n \n Alternative methods for nasotracheal intubation and extubation in a patient with Apert syndrome. 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