title: Case report: quetiapine and refractory hypotension during general anesthesia in the operating room.
abstract: Quetiapine is an atypical antipsychotic with known α-adrenergic antagonism. We present a case of refractory hypotension that occurred after induction of general anesthesia in a patient being treated with quetiapine. This patient was not currently taking antihypertensives and had no known cardiovascular abnormalities. We observed that the hypotension was most responsive to vasopressin. We recommend further investigation regarding the interaction of quetiapine and general anesthesia.
authors.affiliation: From the Department of Anesthesiology and Perioperative Medicine, OHSU, Portland, Oregon.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Poole
authors.forename: Nina
authors.initials: N
authors.lastname: Weber
authors.forename: Michael
authors.initials: M
authors.lastname: Aziz
mesh_terms: D000328:Adult; D000768:Anesthesia, General / Q000009:adverse effects*; D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects / Q000627:therapeutic use; D018692:Antimanic Agents / Q000009:adverse effects / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000009:adverse effects*; D001794:Blood Pressure / Q000187:drug effects; D002245:Carbon Dioxide / Q000097:blood; D006348:Cardiac Surgical Procedures; D003511:Cyclohexanols / Q000009:adverse effects / Q000627:therapeutic use; D003987:Dibenzothiazepines / Q000009:adverse effects*; D057286:Electronic Health Records; D004809:Ephedrine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007022:Hypotension / Q000139:chemically induced* / Q000188:drug therapy; D007431:Intraoperative Complications / Q000139:chemically induced* / Q000188:drug therapy; D000077213:Lamotrigine; D009767:Obesity, Morbid; D009873:Operating Rooms; D010100:Oxygen / Q000097:blood; D010656:Phenylephrine / Q000627:therapeutic use; D000069348:Quetiapine Fumarate; D014227:Triazines / Q000009:adverse effects / Q000627:therapeutic use; D014662:Vasoconstrictor Agents / Q000627:therapeutic use; D014667:Vasopressins / Q000627:therapeutic use; D000069470:Venlafaxine Hydrochloride
chemical_list: D018687:Antidepressive Agents, Second-Generation; D018692:Antimanic Agents; D014150:Antipsychotic Agents; D003511:Cyclohexanols; D003987:Dibenzothiazepines; D014227:Triazines; D014662:Vasoconstrictor Agents; D014667:Vasopressins; D002245:Carbon Dioxide; D010656:Phenylephrine; D000069348:Quetiapine Fumarate; D000069470:Venlafaxine Hydrochloride; D004809:Ephedrine; D010100:Oxygen; D000077213:Lamotrigine