title: Second-Degree Atrioventricular Block Occurring After Tooth Extraction.
abstract: Although cardiac arrhythmias are occasionally associated with dental extractions and dental anesthesia, atrioventricular block is rarely seen during dental procedures. We report a rare case of type I second-degree atrioventricular block (Wenckebach phenomenon) occurring after bilateral extraction of impacted mandibular third molars under general anesthesia in a 16-year-old Japanese girl. Under consultation with a cardiovascular physician, we carefully monitored the patient's vital signs postoperatively, including blood pressure, oxygen saturation, and electrocardiogram, using a bedside monitor. Her postoperative course was uneventful. A 12-lead electrocardiogram the following day revealed no abnormality. In this case, we hypothesize that extubation of the nasotracheal tube or oral/pharyngeal suction might have triggered a vagal reflex that caused type I second-degree atrioventricular block. Our experience indicates that standard cardiovascular monitoring should be used for patients undergoing dental treatment under general anesthesia, even for young, healthy patients, to prevent and detect cardiovascular emergencies.
authors: Department of Oral and Maxillofacial Surgery, Showa University School of Dentistry, Tokyo, Japan.
authors: Takaaki
authors: T
authors: Kamatani
authors: Department of Oral and Maxillofacial Surgery, Showa University School of Dentistry, Tokyo, Japan.
authors: Ayako
authors: A
authors: Akizuki
authors: Department of Oral and Maxillofacial Surgery, Showa University School of Dentistry, Tokyo, Japan.
authors: Seiji
authors: S
authors: Kondo
authors: Department of Oral and Maxillofacial Surgery, Showa University School of Dentistry, Tokyo, Japan.
authors: Tatsuo
authors: T
authors: Shirota
mesh_terms: D000293:Adolescent; D054537:Atrioventricular Block / Q000209:etiology*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008991:Monitoring, Physiologic; D014081:Tooth Extraction / Q000009:adverse effects*; D014095:Tooth, Impacted / Q000601:surgery
keywords: General anesthesia; Tooth extraction; Type I second-degree atrioventricular block