Editorial Type:
Article Category: Case Report
 | 
Online Publication Date: 01 Jan 2018

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
DOI: 10.2344/anpr-66-01-02
Save
Download PDF

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: 26 Nov 2017
Accepted: 14 Apr 2018
  • Download PDF