{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:52:45Z","timestamp":1787025165781,"version":"build-2736575974"},"reference-count":18,"publisher":"American Dental Society of Anesthesiology (ADSA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023]]},"abstract":"<jats:p>We present the case of a 46-year-old man who received ephedrine for hypotension after surgery for a mandibular lesion under intravenous (IV) moderate sedation with dexmedetomidine (DEX) and experienced transient ventricular tachycardia (VT). The patient was scheduled to have cystectomy and multiple apicoectomies for the mandibular periapical infection and the simple bone cyst. Other than obesity, snoring, and a nonalcoholic fatty liver, he denied any other significant medical history, medications, or allergies. The surgery was successful; however, his blood pressure dropped after stopping the DEX infusion. Ephedrine was administered IV several times, which resulted in the onset of VT on the electrocardiogram (ECG). His blood pressure could not be measured at the time, but he was able to respond and breathe independently. A defibrillator was immediately made available. The ECG revealed a spontaneous transition from VT to atrial fibrillation with ST depression. Because he was unable to revert to a normal sinus rhythm, the patient was transferred to a general hospital, where he underwent additional testing. No abnormalities were observed in his heart or brain. After DEX administration, its long-lasting alpha-2 adrenoceptor agonist effects can cause vasodilation and inhibition of sympathetic activity, leading to hypotension in some patients. Should that occur, ephedrine can be used to increase blood pressure, but it may also provoke transient coronary artery spasms and lead to VT. Consequently, extreme caution should be exercised in patients who develop hypotension following DEX administration. We also recognize the significance of regular training sessions, such as advanced cardiac life support programs.<\/jats:p>","DOI":"10.2344\/anpr-70-03-04","type":"journal-article","created":{"date-parts":[[2024,1,14]],"date-time":"2024-01-14T23:24:29Z","timestamp":1705274669000},"page":"184-190","source":"Crossref","is-referenced-by-count":2,"title":["Ventricular Tachycardia Following Ephedrine During Dexmedetomidine Dental Procedural Sedation"],"prefix":"10.2344","volume":"70","author":[{"given":"Shota","family":"Abe","sequence":"first","affiliation":[{"name":"Department of Dental Anesthesiology, Ohu University, School of Dentistry, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanami","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Ohu University, School of Dentistry, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maki","family":"Hamamura","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Ohu University, School of Dentistry, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Tamanoi","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Ohu University, School of Dentistry, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Ohu University, School of Dentistry, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiichiro","family":"Wakamatsu","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Ohu University, School of Dentistry, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Ohu University, School of Dentistry, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyoshi","family":"Kawaai","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Ohu University, School of Dentistry, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinya","family":"Yamazaki","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Ohu University, School of Dentistry, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1191","reference":[{"issue":"(12)","key":"i1878-7177-70-4-184-b01","series-title":"Pharmacotherapy","first-page":"1492","article-title":"Dexmedetomidine-associated bradycardia progressing to pulseless electrical activity: case report and review of the literature","volume":"29","author":"Gerlach","year":"2009","unstructured":"Gerlach\n              AT,\n            \n            \n              Murphy\n              CV.\n            \n          \n          Dexmedetomidine-associated bradycardia progressing to pulseless electrical activity: case report and review of the literature.\nPharmacotherapy.\n2009;\n29(12):\n1492."},{"issue":"(4)","key":"i1878-7177-70-4-184-b02","series-title":"Acta Anaesthesiol Taiwan","first-page":"165","article-title":"Incidence of cardiac arrest increases with the indiscriminate use of dexmedetomidine: a case series and review of published case reports","volume":"49","author":"Bharati","year":"2011","unstructured":"Bharati\n              S,\n            \n            \n              Pal\n              A,\n            \n            \n              Biswas\n              C,\n            \n            \n              Biswas\n              R.\n            \n          \n          Incidence of 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Anesth","first-page":"212","article-title":"Hemodynamic impact of dexmedetomidine administration in 15\u2009656 noncardiac surgical cases","volume":"24","author":"Klinger","year":"2012","unstructured":"Klinger\n              RY,\n            \n            \n              White\n              WD,\n            \n            \n              Hale\n              B,\n            \n            \n              Habib\n              AS,\n            \n            \n              Bennett-Guerrero\n              E.\n            \n          \n          Hemodynamic impact of dexmedetomidine administration in 15\u2009656 noncardiac surgical cases.\nJ Clin Anesth.\n2012;\n24(3):\n212\u2013220."},{"issue":"(4)","key":"i1878-7177-70-4-184-b17","series-title":"Working Group on Guidelines Development for Intravenous Sedation in Dentistry, the Japanese Dental Society of Anesthesiology. Practice guidelines for intravenous conscious sedation in dentistry (second edition, 2017).","first-page":"e1","volume":"65","year":"2018","unstructured":"Working Group on Guidelines Development for Intravenous Sedation in Dentistry, the Japanese Dental Society of Anesthesiology. Practice guidelines for intravenous conscious sedation in dentistry (second edition, 2017).\n          \n            Anesth Prog\n          .\n2018;\n65(4):\ne1\u2013e18.\ndoi:10.2344\/anpr-65-04-15w"},{"key":"i1878-7177-70-4-184-b18","series-title":"2020 AHA advanced cardiac life support (ACLS) guidelines","unstructured":"American Heart Association.\n2020 AHA advanced cardiac life support (ACLS) guidelines.\nSynergy International, Inc.\nSeptember 21, 2022."}],"container-title":["Anesthesia Progress"],"original-title":[],"link":[{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/view\/journals\/anpr\/70\/4\/article-p184.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/meridian.allenpress.com\/anesthesia-progress\/article-pdf\/70\/4\/184\/3316911\/i1878-7177-70-4-184.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/downloadpdf\/journals\/anpr\/70\/4\/article-p184.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/downloadpdf\/journals\/anpr\/70\/4\/article-p184.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,7]],"date-time":"2024-10-07T08:45:13Z","timestamp":1728290713000},"score":1,"resource":{"primary":{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/view\/journals\/anpr\/70\/4\/article-p184.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023]]},"references-count":18,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.2344\/anpr-70-03-04","relation":{},"ISSN":["1878-7177","0003-3006"],"issn-type":[{"value":"1878-7177","type":"electronic"},{"value":"0003-3006","type":"print"}],"subject":[],"published":{"date-parts":[[2023]]}}}