Terlipressin-ephedrine versus ephedrine to treat hypotension at the induction of anesthesia in patients chronically treated with angiotensin converting-enzyme inhibitors: a prospective, randomized, double-blinded, crossover study

Anesthesia and Analgesia
K MeersschaertP Coriat

Abstract

In patients chronically treated with angiotensin converting-enzyme inhibitors (ACEI), typically selected doses of ephedrine do not always restore arterial blood pressure when anesthesia-induced hypotension occurs. We postulated that the administration of terlipressin, an agonist of the vasopressin system, with ephedrine more effectively restores pressure in this setting than the administration of ephedrine alone. This prospective, randomized, cross-over, double-blinded study compared terlipressin combined with ephedrine (n = 19) with ephedrine alone (n = 21) in treating hypotension at the induction of anesthesia in 40 ACEI-treated patients undergoing hypotension (mean arterial blood pressure [MAP] <65 mm Hg or <30% of baseline value) after standardized anesthetic protocol (target-controlled IV anesthesia with propofol). Data are mean +/- SD. Patient characteristics, MAP, and heart rate before and after the induction of anesthesia during hypotensive episodes were not significantly different between the two groups. After the first bolus, MAP was significantly greater in the Terlipressin-Ephedrine group (72 +/- 12 mm Hg versus 65 +/- 8 mm Hg, P < 0.05). The occurrence of a second hypotensive episode (5% versus 71%, P < 0.001), the...Continue Reading

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Citations

Aug 26, 2006·Anesthesia and Analgesia·Leanne Groban, John Butterworth
Nov 21, 2002·Critical Care Medicine·Hans G BoneHugo C Van Aken
Aug 11, 2005·Der Anaesthesist·K BuhreW Buhre
Apr 17, 2007·Der Anaesthesist·U Schirmer, W Schürmann
May 27, 2004·Natural Product Reports·Kenneth W Bentley
Nov 30, 2019·Experimental and Therapeutic Medicine·Hyunjee Kim
Aug 26, 2006·Anesthesiology·Tanja A Treschan, Jürgen Peters
Mar 15, 2006·Current Opinion in Anaesthesiology·Stefan JochbergerMartin W Dünser
Apr 27, 2019·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Justin CoxKeshav R Nayak
Feb 28, 2004·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Ilan MatokGideon Paret
Apr 1, 2008·Journal of Cardiothoracic and Vascular Anesthesia·John G T Augoustides
Aug 8, 2008·Best Practice & Research. Clinical Anaesthesiology·Matthias LangeAndrea Morelli
Dec 1, 2009·Journal of Cardiothoracic and Vascular Anesthesia·Natalie F Holt, Kenneth L Haspel

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