Key result
Preoperative 24-hour ARB discontinuation fails to prevent severe refractory hypotension during anesthesia requiring vasopressin rescue.
Why the study?
Angiotensin receptor blockers can cause severe hypotension during general anesthesia despite preoperative discontinuation, and optimal timing for withholding them is unclear.
Comparison
Discontinuation of ARB 24 hours preoperatively vs hypotension occurrence
Design
Case report
Authors
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Should not yet change ARB discontinuation practices; hypothesis-generating for vasopressin in refractory intraoperative hypotension.
Case Report (n=1)
No
This case highlights that discontinuing angiotensin receptor blockers 24 hours prior to surgery may be insufficient to prevent severe, refractory hypotension during general anesthesia.
Nabbi et al. (2013) conducted a case report in Hypertension (n=1). Angiotensin receptor blocker (valsartan/hydrochlorothiazide) was evaluated on Refractory hypotension during general anesthesia. A patient developed severe refractory hypotension during general anesthesia despite discontinuing her angiotensin receptor blocker 24 hours preoperatively, which was successfully treated with vasopressin.
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