Severe hypotension after induction of general anesthesia in a patient receiving an angiotensin II receptor antagonist and an alpha-blocker

摘要

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.