title: A 13-Year-Old Girl in Trigeminy During Anesthesia for Outpatient Dental Surgery: A Case Report.
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.
authors.affiliation: Certified Specialist in Dental Anesthesia in Ontario, Canada (RCDSO).
authors.forename: Bryan Neil
authors.initials: BN
authors.lastname: Waxman
mesh_terms: D000293:Adolescent; D000553:Ambulatory Care; D000766:Anesthesia, Dental; D000768:Anesthesia, General; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D018880:Atrial Premature Complexes / Q000175:diagnosis; D002037:Bundle-Branch Block / Q000175:diagnosis; D016854:Dental Anxiety / Q000523:psychology; D003729:Dental Care; D004562:Electrocardiography / Q000379:methods; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D008738:Methyl Ethers / Q000008:administration & dosage; D008874:Midazolam / Q000008:administration & dosage; D009609:Nitrous Oxide / Q000008:administration & dosage; D011229:Preanesthetic Medication; D015742:Propofol / Q000008:administration & dosage; D000077149:Sevoflurane; D018879:Ventricular Premature Complexes / Q000175:diagnosis*
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D006993:Hypnotics and Sedatives; D008738:Methyl Ethers; D000077149:Sevoflurane; D009609:Nitrous Oxide; D008874:Midazolam; D005283:Fentanyl; D015742:Propofol
keywords: Dental anesthesia; Management of pediatric cardiac arrhythmias; Pediatric cardiac arrhythmias; Trigeminy