{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T01:06:58Z","timestamp":1772759218083,"version":"3.50.1"},"reference-count":4,"publisher":"American Dental Society of Anesthesiology (ADSA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,6,1]]},"abstract":"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.<\/jats:p>","DOI":"10.2344\/anpr-68-03-05","type":"journal-article","created":{"date-parts":[[2022,7,18]],"date-time":"2022-07-18T19:15:09Z","timestamp":1658171709000},"page":"38-40","source":"Crossref","is-referenced-by-count":5,"title":["A Case of Wide QRS Tachycardia After the Local Administration of Epinephrine to Reduce Bleeding During General Anesthesia"],"prefix":"10.2344","volume":"69","author":[{"given":"Nayuka","family":"Usami","sequence":"first","affiliation":[{"name":"*Department of Dental Anesthesiology, Osaka University Graduate School of Dentistry, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Midori","family":"Tooyama","sequence":"additional","affiliation":[{"name":"*Department of Dental Anesthesiology, Osaka University Graduate School of Dentistry, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wakana","family":"Oda","sequence":"additional","affiliation":[{"name":"*Department of Dental Anesthesiology, Osaka University Graduate School of Dentistry, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuu","family":"Kawamoto","sequence":"additional","affiliation":[{"name":"*Department of Dental Anesthesiology, Osaka University Graduate School of Dentistry, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saki","family":"Kishimoto","sequence":"additional","affiliation":[{"name":"*Department of Dental Anesthesiology, Osaka University Graduate School of Dentistry, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayano","family":"Minamide","sequence":"additional","affiliation":[{"name":"\u2020Rakuwakai Otowa Hospital, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hitoshi","family":"Niwa","sequence":"additional","affiliation":[{"name":"*Department of Dental Anesthesiology, Osaka University Graduate School of Dentistry, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1191","published-online":{"date-parts":[[2022,7,18]]},"reference":[{"key":"2022071819150110400_i1878-7177-69-2-38-b01","unstructured":"Murakawa\n T,\n \n \n Koh\n H,\n \n \n Tsubo\n T,\n \n \n Ishihara\n H,\n \n \n Matsuki\n A.\n \n \n Two case of circulatory failure after local infiltration of epinephrine during tonsillectomy.\n\t\t\t\t\tMasui.\n\t\t\t\t\t1998;47:955\u2013962."},{"key":"2022071819150110400_i1878-7177-69-2-38-b02","doi-asserted-by":"crossref","unstructured":"O-uchi\n J,\n \n \n Komukai\n K,\n \n \n Tohyama\n J,\n \n et al.\n \n Coronary artery spasm discovered in thorough examination of perioperative VT in a 26-year-old Japanese male.\n\t\t\t\t\tJpn Heart J.\n\t\t\t\t\t2003;44:1021\u20131026.","DOI":"10.1536\/jhj.44.1021"},{"key":"2022071819150110400_i1878-7177-69-2-38-b03","doi-asserted-by":"crossref","unstructured":"Lee\n JY,\n \n \n Hong\n SJ,\n \n \n Chon\n JY,\n \n \n Kwon\n SY.\n \n \n Cardiac arrest induced by submucosal injection of epinephrine in a patient with variant angina.\n\t\t\t\t\tRhinology.\n\t\t\t\t\t2010;48:251\u2013253.","DOI":"10.4193\/Rhin09.059"},{"key":"2022071819150110400_i1878-7177-69-2-38-b04","doi-asserted-by":"crossref","unstructured":"Hoshi\n T,\n \n \n Suzuki\n T,\n \n \n Somei\n M,\n \n \n Iijima\n T,\n \n \n Kurihara\n Y.\n \n \n Sudden tachycardia due to submucosal migration of an epinephrine-soaked swab during nasal intubation.\n\t\t\t\t\tAnesth Prog.\n\t\t\t\t\t2018;65:259\u2013260.","DOI":"10.2344\/anpr-66-01-02"}],"container-title":["Anesthesia Progress"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/meridian.allenpress.com\/anesthesia-progress\/article-pdf\/69\/2\/38\/3087568\/i1878-7177-69-2-38.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/meridian.allenpress.com\/anesthesia-progress\/article-pdf\/69\/2\/38\/3087568\/i1878-7177-69-2-38.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,18]],"date-time":"2024-01-18T19:50:51Z","timestamp":1705607451000},"score":1,"resource":{"primary":{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/view\/journals\/anpr\/69\/2\/article-p38.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,1]]},"references-count":4,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,7,18]]},"published-print":{"date-parts":[[2022,6,1]]}},"URL":"https:\/\/doi.org\/10.2344\/anpr-68-03-05","relation":{},"ISSN":["1878-7177","0003-3006"],"issn-type":[{"value":"1878-7177","type":"electronic"},{"value":"0003-3006","type":"print"}],"subject":[],"published":{"date-parts":[[2022,6,1]]}}}