tailieunhanh - báo cáo khoa học: " Tamsulosin-induced severe hypotension during general anesthesia: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Tamsulosin-induced severe hypotension during general anesthesia: a case report | Kumar and Khan Journal of Medical Case Reports 2010 4 365 http content 4 1 365 jAg JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access Tamsulosin-induced severe hypotension during general anesthesia a case report Dileep Kumar Fauzia Anis Khan Abstract Introduction Tamsulosin a selective a1-adrenergic receptor a1-AR antagonist is a widely prescribed first-line agent for benign prostatic hypertrophy BPH . Its interaction with anesthetic agents has not been described. Case presentation We report the case of 54-year-old Asian man undergoing elective left thyroid lobectomy. The only medication the patient was taking was tamsulosin mg for the past year for BPH. He developed persistent hypotension during the maintenance phase of anesthesia while receiving oxygen nitrous oxide and 1 isoflurane. The hypotension could have been attributable to a possible interaction between inhalational anesthetic and tamsulosin. Conclusion Vigilance for unexpected hypotension is important in surgical patients who are treated with selective a1-AR blockers. If hypotension occurs vasopressors that act directly on adrenergic receptors could be more effective. Introduction Tamsulosin benzenesulfonamide is a uroselective a1A-adrenergic receptor a1A-AR antagonist primarily used for patients with benign prostatic hyperplasia BPH presenting with lower urinary tract symptoms 1 . The recommended dose is mg or mg with a half-life of nine to 15 hours. It is extensively metabolized by the liver. Currently a1-adrenergic receptor a1-AR antagonists are commonly prescribed by physicians as first-line agents to treat BPH a common condition of aging men. a1-AR antagonists exert their effects by blocking a1-AR-mediated contraction of the prostatic smooth muscle cells and bladder neck 2 . There are three a1-AR subtypes a1A a1B and a1D. Terazosin doxazosin and alfu-zosin are a1-AR antagonists that show equal affinity for all a1-AR subtypes 3 . Tamsulosin does not .