[논문]Junctional rhythm with severe hypotension following infiltration of lidocaine containing epinephrine during dental surgery

Jeon, Younghoon; Shim, Jihye; Kim, Hyunjee

doi:10.17245/jdapm.2020.20.2.89

Junctional rhythm with severe hypotension following infiltration of lidocaine containing epinephrine during dental surgery 원문보기

Journal of dental anesthesia and pain medicine, v.20 no.2, 2020년, pp.89 - 93

Jeon, Younghoon (Department of Anesthesiology and Pain Medicine, School of Dentistry, Kyungpook National University) , Shim, Jihye (Department of Anesthesiology and Pain Medicine, School of Medicine, Kyungpook National University) , Kim, Hyunjee (Department of Anesthesiology and Pain Medicine, School of Medicine, Kyungpook National University)

Abstract ▼ AI-Helper

We experienced an unusual case of accelerated junctional rhythm with severe hypotension after infiltration of lidocaine containing epinephrine during dental surgery under general anesthesia. The patient's electrocardiogram exhibited retrograde P-waves following the QRS complex, which could be misinterpreted as ST-segment depression. As a temporary measure, administration of ephedrine restored the patient's blood pressure to normal levels. The importance of this case lies in its demonstration of an unexpected and serious side effect of commonly used epinephrine infiltration. This case also highlights the need for accurate interpretation of the electrocardiogram and comprehensive understanding of best practices for patient management.

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Regional infiltration of local anesthetics that contain epinephrine is widely used for pain control and reducing blood loss during surgery; however, systemic side effects of this procedure—such as hypertension, tachycardia, and other arrhythmias—have been documented in the literature [5,6]. In this report, we present our experience with a patient who developed intraoperative junctional rhythm and severe hypotension following regional injection of a local anesthetic that contained epinephrine.

참고문헌 (15)

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10 Lee KL Chun HM Liem LB Sung RJ Effect of adenosine and verapamil in catecholamine-induced accelerated atrioventricular junctional rhythm: insights into the underlying mechanism Pacing Clin Electrophysiol 1999 22 866 870 10392383

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12 Breslow MJ Evers AS Lebowitz P Successful treatment of accelerated junctional rhythm with propranolol: possible role of sympathetic stimulation in the genesis of this rhythm disturbance Anesthesiology 1985 62 180 182 3970369
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DOI : 10.17245/jdapm.2020.20.2.89 [무료]
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