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Canadian Journal of Anesthesia, Vol 38, 499-501, Copyright © 1991 by Canadian Anesthesiologists' Society

ARTICLES

Idiopathic orthostatic hypotension, midodrine, and anaesthesia

PJ Osborne and LW Lee
Department of Anesthesiology, University of British Columbia, Vancouver.

A patient with idiopathic orthostatic hypotension receiving chronic oral midodrine therapy required anaesthesia for coronary artery bypass grafting. A perioperative infusion of phenylephrine was substituted for midodrine, an alpha-2 agonist, enabling hypotension resulting from low systemic vascular resistance to be controlled easily. Anticipated adrenergic receptor denervation hypersensitivity was noted. The only significant perioperative problem was one episode of syncope from orthostatic hypotension during the reambulation period.




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Copyright © 1991 by the Canadian Anesthesiologists' Society.