Editorial Type:
Article Category: Case Report
| Online Publication Date: Jan 01, 2018
Sudden Tachycardia Due to Submucosal Migration of an Epinephrine-Soaked Swab During Nasal Intubation
Sudden Tachycardia Due to Submucosal Migration of an Epinephrine-Soaked Swab During Nasal Intubation
DDS,
MD, PhD,
MD, PhD,
DDS, PhD, and
DDS
Page Range: 259 – 260
A 23-year-old healthy man was scheduled for extraction of his mandibular third molars under general anesthesia with nasotracheal intubation. Sudden sinus tachycardia up to 170 beats/min occurred when applying an epinephrine solution-soaked swab into the nasal cavity for preventing epistaxis during intubation. This was presumably evoked by submucosal migration of the swab into a false passage created because of the force applied during a prior failed attempt at nasal passage of the tracheal tube, and rapid epinephrine absorption by the traumatized mucosa. The causes of the unexpected severe tachycardia in our patient are discussed.
Copyright: © 2018 by the American Dental Society of Anesthesiology
Contributor Notes
Address correspondence to Takashi Suzuki, MD, PhD, Department of Anesthesiology, Showa University Koto Toyosu Hospital, 5-1-38 Toyosu, Koto-ku, Tokyo 135-8577, Japan; tksuzuki@med.showa-u.ac.jp.
Received: Nov 26, 2017
Accepted: Apr 14, 2018