title: [Severe hypotension after induction of general anesthesia in a patient receiving an angiotensin II receptor antagonist and an alpha-blocker].
abstract: We report severe hypotension after induction of general anesthesia in a patient receiving an angiotensin II receptor antagonist and an alpha-blocker. A 50-year-old man with diabetes mellitus who had been treated with candesartan cilexetil and doxazosin was scheduled for vitreous surgery. He was operated on for vitreous surgery three times. He developed severe hypotension after induction of anesthesia with propofol and fentanyl on two occasions, when he was taking candesartan cilexetil and doxazosin. Repeated injections of intravenous ephedrine could not raise the blood pressure. After discontinuation of both drugs, although he developed hypotension after induction of anesthesia with propofol and fentanyl, hypotension was mild and responded promptly to intravenous ephedrine.
authors.affiliation: Department of Anesthesiology, Fukuoka University Hospital, Fukuoka.
authors.forename: Shiho
authors.initials: S
authors.lastname: Shibata
authors.forename: Matsuko
authors.initials: M
authors.lastname: Matsunaga
authors.forename: Mihori
authors.initials: M
authors.lastname: Oikawa
authors.forename: Keiichi
authors.initials: K
authors.lastname: Nitahara
authors.forename: Kazuo
authors.initials: K
authors.lastname: Higa
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000009:adverse effects*; D000768:Anesthesia, General / Q000009:adverse effects*; D047228:Angiotensin II Type 1 Receptor Blockers / Q000009:adverse effects*; D000959:Antihypertensive Agents / Q000009:adverse effects; D003681:Dehydration / Q000150:complications; D048909:Diabetes Complications / Q000150:complications; D005283:Fentanyl / Q000009:adverse effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007022:Hypotension / Q000139:chemically induced / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D015742:Propofol / Q000009:adverse effects; D014822:Vitreous Body / Q000601:surgery
chemical_list: D000317:Adrenergic alpha-Antagonists; D047228:Angiotensin II Type 1 Receptor Blockers; D000959:Antihypertensive Agents; D005283:Fentanyl; D015742:Propofol