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.
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DOI：
10.2344/anpr-66-01-02
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发表时间：
2018-01-01
影响因子：
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通讯作者：
Kurihara, Yuka
中科院分区：
文献类型：
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作者：
Hoshi, Tsuyoshi;Suzuki, Takashi;Kurihara, Yuka
一名23岁的健康男子计划在全麻下经鼻气管插管拔除他的下颌第三磨牙。在插管过程中，鼻腔内使用肾上腺素溶液浸泡的棉签预防鼻出血时，突然出现高达170次/分钟的窦性心动过速。这可能是由于拭子在粘膜下迁移到一个假通道中而引起的，这是由于先前尝试鼻腔插管失败时施加的力，以及受创的粘膜对肾上腺素的快速吸收。对本病患者发生意外严重心动过速的原因进行了讨论。
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.