| Autor: |
Gen Owada, Hideo Nishizawa, Yuki Matoyama, Eri Watanabe, Keigo Mitsuda, Naoki Kaneko, Yasuhiro Kimura, Taikan Nanao, Junichi Fujimoto |
| Jazyk: |
angličtina |
| Rok vydání: |
2023 |
| Předmět: |
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| Zdroj: |
Case Reports in Anesthesiology, Vol 2023 (2023) |
| Druh dokumentu: |
article |
| ISSN: |
2090-6390 |
| DOI: |
10.1155/2023/1745373 |
| Popis: |
5-Aminolevulinic acid (5-ALA) is used for the photodynamic diagnosis of malignant tumors and has been effectively utilized to improve the complete resection rate and reduce the risk of tumor recurrence. However, intraoperative hypotension is a common adverse effect of oral 5-ALA, and it occasionally progresses to severe prolonged hypotension requiring high-dose catecholamine administration. We report a case of intraoperative hypotension due to oral 5-ALA in which arginine vasopressin (AVP) administration was effective for increasing the blood pressure. A 77-year-old man scheduled for a craniotomy for glioma was administered 5-ALA orally before surgery. After the induction of anesthesia, his blood pressure decreased substantially. Although we administered various vasopressor agents, hypotension was prolonged. However, after starting a continuous administration of AVP, the systolic blood pressure increased, and the hemodynamic parameters remained stable during the remainder of the operation. 5-ALA administration may lower blood pressure by inducing nitric oxide production, and AVP inhibits inducible nitric oxide synthase messenger RNA expression and interleukin-1β-stimulated nitric oxide production. In light of these mechanisms, AVP may be a reasonable treatment agent for hypotension induced by 5-ALA. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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