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A Case of Wide QRS Tachycardia After the Local Administration of Epinephrine to Reduce Bleeding During General Anesthesia
Nayuka Usami DDS, PhD,
 Midori Tooyama DDS, PhD,
 Wakana Oda DDS, PhD,
 Yuu Kawamoto DDS,
 Saki Kishimoto DDS,
 Ayano Minamide DDS, and
 Hitoshi Niwa DDS, PhD
Article Category: Brief Report
Volume/Issue: Volume 69: Issue 2
Online Publication Date: Jul 18, 2022
DOI: 10.2344/anpr-68-03-05
Page Range: 38 – 40

. Figure 1. Transient (∼22 seconds) ventricular tachycardia with a pulse. Electrocardiogram (leads II, V5, aVR), arterial blood pressure, and pulse oximetry waveforms during the wide QRS tachycardia event. DISCUSSION Previous studies have reported epinephrine-induced arrhythmias for surgeries involving the head and neck region under general anesthesia using sevoflurane or desflurane even though these agents are less likely to cause an arrhythmia compared with other inhalational anesthetics like

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Junctional Rhythm Preoperatively and During General Anesthesia for Oral and Maxillofacial Surgery
Naotaka Kishimoto DDS, PhD,
 Ikue Kinoshita DDS, and
 Yoshihiro Momota DDS, PhD
Article Category: Case Report
Volume/Issue: Volume 64: Issue 3
Online Publication Date: Jan 01, 2017
DOI: 10.2344/anpr-64-03-08
Page Range: 165 – 167

Junctional rhythm is a common arrhythmia that may appear during the perioperative period. It is diagnosed, usually transiently, in about 20% of patients under general anesthesia. 1 – 3 We report our experience with a case in which junctional rhythm was observed preoperatively and again during general anesthesia. We hypothesize that these episodes were due to different causes. CASE REPORT A 19-year-old woman (height 159 cm, weight 50 kg) was scheduled to undergo bilateral sagittal split ramus osteotomy after being

Figure 3 ; Incidence of arrhythmias during myocardial reperfusion The difference in the incidence of arrhythmias was analyzed using a χ2 test, and probability values (p) less than 0.05 were considered statistically significant. *Significant difference (p<0.05) compared with the Control group. The incidence of arrhythmias during myocardial reperfusion was 75.0% in the Control group ; this incidence decreased significantly to 12.5% in the Post group and 12.5% in the Pre + Post group.
<bold>Figure 3</bold>
Figure 3

Incidence of arrhythmias during myocardial reperfusion

The difference in the incidence of arrhythmias was analyzed using a χ2 test, and probability values (p) less than 0.05 were considered statistically significant.

*Significant difference (p<0.05) compared with the Control group.

The incidence of arrhythmias during myocardial reperfusion was 75.0% in the Control group ; this incidence decreased significantly to 12.5% in the Post group and 12.5% in the Pre + Post group.

Figure 1.; Initial appearance of arrhythmia on the anesthesia monitor. Patient's baseline normal sinus rhythm converting to wide-complex rhythm with a rate in the 90s. This occurred after administration of neuromuscular blockade reversal agents.
Jonathan D. Rizner,
 Heather L. Bartlett, and
 Robert E. Shaw
Figure 1.
Figure 1.

Initial appearance of arrhythmia on the anesthesia monitor. Patient's baseline normal sinus rhythm converting to wide-complex rhythm with a rate in the 90s. This occurred after administration of neuromuscular blockade reversal agents.

Figure 3.; Twelve-lead electrocardiogram (EKG) in the postanesthesia care unit after recurrence of arrhythmia. EKG obtained after wide complex rhythm recurred, showing wide complex rhythm with a rate in the 90s.
Jonathan D. Rizner,
 Heather L. Bartlett, and
 Robert E. Shaw
Figure 3.
Figure 3.

Twelve-lead electrocardiogram (EKG) in the postanesthesia care unit after recurrence of arrhythmia. EKG obtained after wide complex rhythm recurred, showing wide complex rhythm with a rate in the 90s.

Figure 1.; Transient (∼22 seconds) ventricular tachycardia with a pulse. Electrocardiogram (leads II, V5, aVR), arterial blood pressure, and pulse oximetry waveforms during the wide QRS tachycardia event.
Nayuka Usami,
 Midori Tooyama,
 Wakana Oda,
 Yuu Kawamoto,
 Saki Kishimoto,
 Ayano Minamide, and
 Hitoshi Niwa
Figure 1.
Figure 1.

Transient (∼22 seconds) ventricular tachycardia with a pulse. Electrocardiogram (leads II, V5, aVR), arterial blood pressure, and pulse oximetry waveforms during the wide QRS tachycardia event.

Figure 1 ; Lead II from a preoperative 12-lead electrocardiogram. The patient's heart rate was 48 beats per minute when the retrograde inverted P wave appeared.
Naotaka Kishimoto,
 Ikue Kinoshita, and
 Yoshihiro Momota
<bold>Figure 1</bold>
Figure 1

Lead II from a preoperative 12-lead electrocardiogram. The patient's heart rate was 48 beats per minute when the retrograde inverted P wave appeared.

Figure 2 ; Electrocardiogram, lead II, during general anesthesia. (A) Normal sinus rhythm changed to a junctional rhythm (normal P wave converted to a retrograde inverted P wave). Heart rate was 85 beats per minute (bpm). (B) Junctional rhythm changed to normal sinus rhythm (retrograde inverted P wave converted to a normal P wave). Heart rate was 80 bpm.
Naotaka Kishimoto,
 Ikue Kinoshita, and
 Yoshihiro Momota
<bold>Figure 2</bold>
Figure 2

Electrocardiogram, lead II, during general anesthesia. (A) Normal sinus rhythm changed to a junctional rhythm (normal P wave converted to a retrograde inverted P wave). Heart rate was 85 beats per minute (bpm). (B) Junctional rhythm changed to normal sinus rhythm (retrograde inverted P wave converted to a normal P wave). Heart rate was 80 bpm.

Anesthetic Management of a Patient With Catecholaminergic Polymorphic Ventricular Tachycardia
Yoshiki Shionoya DDS, PhD,
 Kaoru Hirayama DDS,
 Kaho Saito DDS,
 Eriko Kawasaki DDS,
 Yoko Kantake DDS,
 Hazuki Okamoto DDS, PhD,
 Takahiro Goi DDS,
 Katsuhisa Sunada DDS, PhD, and
 Kiminari Nakamura DDS, PhD
Article Category: Case Report
Volume/Issue: Volume 69: Issue 2
Online Publication Date: Jul 18, 2022
DOI: 10.2344/anpr-68-04-03
Page Range: 24 – 29

significant risk for cardiac events, including fatal arrhythmia. After discussion with the treating oral surgeon, the decision was made to treat her using IV moderate sedation (as assessed using the Observer's Assessment of Alertness/Sedation (OAA/S) scale for a target score of 3) to avoid endogenous catecholamine surges secondary to fear/anxiety or inadequate anesthesia. The preoperative evaluation revealed a BP and HR of 107/47 mm Hg and 57 bpm, respectively. Her percutaneous oxygen saturation (SpO 2 ) was 97% on room air. No abnormalities were detected on routine

Pronounced QT Prolongation During General Anesthesia in a Child with Left Ventricular Noncompaction Cardiomyopathy: A Case Report
Mika Nishikawa DDS,
 Kazumi Takaishi DDS, PhD,
 Marina Takata DDS,
 Osamu Sasajima DDS,
 Shigeki Joseph Luke Fujiwara DDS, PhD,
 Satoru Eguchi DDS, PhD, and
 Shinji Kawahito MD, PhD
Article Category: Brief Report
Volume/Issue: Volume 70: Issue 3
Online Publication Date: Oct 18, 2023
DOI: 10.2344/anpr-70-02-12
Page Range: 137 – 139

Left ventricular noncompaction cardiomyopathy (LVNC) is a very rare congenital cardiac muscle disorder in which the normal condensation or compaction of the myocardium is impaired. 1 The resulting myocardium appears thick and spongy rather than developing as smooth and firm. Although presentation can vary, LVNC can cause heart failure similar to dilated cardiomyopathy, embolism as a result of mural thrombosis, or electrocardiographic abnormalities including fatal arrhythmias, and it can be associated with neuromuscular diseases. 2