Kumar Dileep, Khan Fauzia Anis
Department of Anesthesia, Aga Khan University PO Box 3500, Stadium Road, Karachi, Pakistan.
J Med Case Rep. 2010 Nov 17;4:365. doi: 10.1186/1752-1947-4-365.
Tamsulosin, a selective α1-adrenergic receptor (α1-AR) antagonist, is a widely prescribed first-line agent for benign prostatic hypertrophy (BPH). Its interaction with anesthetic agents has not been described.
We report the case of 54-year-old Asian man undergoing elective left thyroid lobectomy. The only medication the patient was taking was tamsulosin 0.4 mg for the past year for BPH. He developed persistent hypotension during the maintenance phase of anesthesia while receiving oxygen, nitrous oxide and 1% isoflurane. The hypotension could have been attributable to a possible interaction between inhalational anesthetic and tamsulosin.
Vigilance for unexpected hypotension is important in surgical patients who are treated with selective α1-AR blockers. If hypotension occurs, vasopressors that act directly on adrenergic receptors could be more effective.
坦索罗辛是一种选择性α1肾上腺素能受体（α1-AR）拮抗剂，是治疗良性前列腺增生（BPH）广泛使用的一线药物。其与麻醉剂的相互作用尚未见报道。
我们报告一例54岁亚洲男性接受择期左甲状腺叶切除术。该患者过去一年仅服用坦索罗辛0.4mg治疗BPH。在麻醉维持期，当给予氧气、氧化亚氮和1%异氟烷时，他出现了持续性低血压。低血压可能归因于吸入性麻醉剂与坦索罗辛之间可能的相互作用。
对于接受选择性α1-AR阻滞剂治疗的手术患者，警惕意外低血压很重要。如果发生低血压，直接作用于肾上腺素能受体的血管升压药可能更有效。
