Abstract

A 13-year-old girl presented to a private office for dental rehabilitation under general anesthesia. The patient had a previous uneventful anesthetic 5 years prior in the same office by another dental anesthesiologist. The patient was highly anxious and would not allow monitors placed prior to induction. After an uneventful mask induction with sevoflurane, nitrous oxide, and oxygen, monitors were placed and a 22-gauge intravenous cannula inserted. The initial rhythm on the electrocardiogram was trigeminy interspersed with normal sinus rhythm. The volatile anesthetic sevoflurane was discontinued immediately, and intravenous anesthesia was started but still the patient was consistently entering trigeminy. The patient was always hemodynamically stable and never hypoxic. An in-depth discussion of the case and discussion of ventricular dysrhythmias is presented.