Korean J Anesthesiol.  2009 Aug;57(2):242-245. 10.4097/kjae.2009.57.2.242.

Acute pulmonary edema due to phenylephrine injection in patient receiving long-term beta-blocker therapy: A case report

• Kim HT
• Jang IS
• An SK

• KMID: 2238099
• DOI: http://doi.org/10.4097/kjae.2009.57.2.242

Abstract

During administration of anesthesia, intraoperative blood pressure control is very important. Sometimes a hypertensive or anti-hypertensive agent is used in order to maintain blood pressure at an adequate level; alpha-agonist and beta-blocker are drugs frequently used. Alpha-agonists are used in various ways including their application together with local anesthetics during an operation for the purpose of vasoconstriction, to control systemic absorption of local anesthetics, to extend the duration of action, or to reduce bleeding from the surgical site. In addition, alpha-agonists are used in cardiopulmonary resuscitation. Beta-blockers are used widely as a therapeutic agent for hypertension, angina, and arrhythmia, and to lower portal pressure in liver cirrhosis. Here, we are reporting the case of acute pulmonary edema that occurred after the administration of phenylephrine, in order to maintain blood pressure in a 52-year-old female patient with liver cirrhosis. The patient was underwent emergent decompressive craniectomy for intracranial hemorrhage without acknowledging her long-term use of a beta-blocker medication.

Keyword

Beta-blocker; Phenylephrine; Pulmonary edema

MeSH Terms

Absorption
Anesthesia
Anesthetics, Local
Arrhythmias, Cardiac
Blood Pressure
Cardiopulmonary Resuscitation
Decompressive Craniectomy
Female
Hemorrhage
Humans
Hypertension
Intracranial Hemorrhages
Liver Cirrhosis
Middle Aged
Phenylephrine
Portal Pressure
Pulmonary Edema
Vasoconstriction
Anesthetics, Local
Phenylephrine