Propranolol Use for a Psychiatric Indication Contributing to Intra-anesthetic Hypotension: A Case Report
- 0. Both the authors contributed equally
- 1. Department of Pediatric Medicine, St. Jude Children’s Research Hospital, USA
- 2. Department of Oncology, St. Jude Children’s Research Hospital, USA
- 3. Department of Pediatric Medicine, St. Jude Children’s Research Hospital, USA
Abstract
Intra-operative hypotension is generally responsive to decreasing anesthetic
depth and/or intravenous fluid boluses. We present a 20-year-old male with multiple
refractory intra-anesthetic hypotensive episodes, determined to have multifactorial
etiology. Using propranolol to treat anxiety and Asperger’s syndrome, an indication
likely to increase due to recent research efforts, was identified as a key contributing
factor. There are no published recommendations regarding the peri-operative
management of beta-blocker therapy prescribed for non-cardiac indications, and
anesthesiologists should consider preoperative discontinuation because there is no
elevated risk of major adverse cardiac events