Key result
Vasopressin administration successfully stabilized systemic blood pressure in two patients who developed refractory hypotension intraoperatively after continuing ACEI or ARB therapy prior to general anesthesia.
Why the study?
Does vasopressin improve ACEI- or ARB-induced refractory hypotension in patients undergoing general anesthesia?
Case Report (n=2)
No
Does vasopressin improve ACEI- or ARB-induced refractory hypotension in patients undergoing general anesthesia?
Vasopressin successfully reversed ACEI/ARB-induced refractory hypotension during general anesthesia for oral surgery.
May support vasopressin for ACEI/ARB-related refractory hypotension; hypothesis-generating and should not yet change practice.
Two case reports present the use of vasopressin for treating refractory hypotension associated with continued angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) therapy prior to general anesthesia for oral surgery. Both patients were treated in an ambulatory dental surgery clinic and took either their ACEI or ARB medication for hypertension within 24 hours prior to undergoing an intubated general anesthetic. Persistent profound hypotension was encountered intraoperatively that was refractory to treatment with traditional methods. However, the ACEI- or ARB-induced refractory hypotension was successfully managed with the administration of vasopressin.
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Waters et al. (2022) conducted a case report in Refractory hypotension during general anesthesia (n=2). Vasopressin was evaluated on Stabilization of mean arterial pressure (MAP). Vasopressin administration successfully stabilized systemic blood pressure in two patients who developed refractory hypotension intraoperatively after continuing ACEI or ARB therapy prior to general anesthesia.
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