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- Title
Catecholamine-Resistant Hypotension Following Induction for Spinal Exploration.
- Authors
Trotter, Jason
- Abstract
Systemic blood pressure is regulated by 3 mechanisms: the sympathetic nervous system, the renin-angiotensin system, and the arginine-vasopressin system. The use of angiotensin II receptor blockers and angiotensin- converting enzyme inhibitors has become prevalent in the medical treatment of hypertension. These classes of medications inhibit the renin-angiotensin-aldosterone system, specifically the action of angiotensin II, a potent vasoconstrictor. This article describes the case of a 67-year-old man undergoing surgery for a spinal exploration who had hypotension following induction that was refractory to fluid administration and agents with mixed a-ß agonistic activity but responded to a vasopressin and phenylephrine infusion. Following the case study is a discussion of the impact that angiotensin II inhibitors may have on a patient undergoing general anesthesia and the role of vasopressin in reversing catecholamine-resistant hypotension.
- Subjects
SPINAL surgery; ANESTHESIA; ACE inhibitors; BLOOD pressure; DRUG interactions; HYPERTENSION; ANTIHYPERTENSIVE agents; HYPOTENSION; INTRAOPERATIVE monitoring; LOSS of consciousness; PATIENTS; SURGERY; SYMPATHETIC nervous system; SURGICAL therapeutics; TRACHEA intubation; VASOCONSTRICTORS; RENIN-angiotensin system; MORBID obesity; PHARMACODYNAMICS; DISEASE risk factors
- Publication
AANA Journal, 2012, Vol 80, Issue 1, p55
- ISSN
0094-6354
- Publication type
Article