Jang MJ, Kim JH, Jeong HJ. Uncontrolled high blood pressure under total intravenous anesthesia with propofol and remifentanil: A case report. World J Clin Cases 2022; 10(26): 9411-9416 [PMID: 36159423 DOI: 10.12998/wjcc.v10.i26.9411]
Corresponding Author of This Article
Hae Jeong Jeong, PhD, Professor, Anesthesiology and Pain Medicine, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang 10408, South Korea. hiha3758@ncc.re.kr
Research Domain of This Article
Anesthesiology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Sep 16, 2022; 10(26): 9411-9416 Published online Sep 16, 2022. doi: 10.12998/wjcc.v10.i26.9411
Uncontrolled high blood pressure under total intravenous anesthesia with propofol and remifentanil: A case report
Min Jung Jang, Jee Hee Kim, Hae Jeong Jeong
Min Jung Jang, Jee Hee Kim, Hae Jeong Jeong, Anesthesiology and Pain Medicine, National Cancer Center, Goyang 10408, South Korea
Author contributions: Jang MJ, Kim JH, and Jeong HJ contributed to the conception and design of the study; Jang MJ drafted the manuscript; Kim JH and Jeong HJ made critical revisions; all authors have read and approve the final manuscript.
Informed consent statement: A written informed consent was obtained from the patient for publication of this case report.
Conflict-of-interest statement: The authors declare that there is no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hae Jeong Jeong, PhD, Professor, Anesthesiology and Pain Medicine, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang 10408, South Korea. hiha3758@ncc.re.kr
Received: April 10, 2022 Peer-review started: April 10, 2022 First decision: May 30, 2022 Revised: June 6, 2022 Accepted: August 12, 2022 Article in press: August 12, 2022 Published online: September 16, 2022 Processing time: 144 Days and 15.2 Hours
Abstract
BACKGROUND
Although propofol generally reduces blood pressure, rarely, it causes hypertension. However, the mechanism by which propofol increases blood pressure has not been established, and so far, there are only a few reported cases.
CASE SUMMARY
A 46-year-old woman, diagnosed with thyroid cancer, was administered general anesthesia with propofol and remifentanil for a thyroid lobectomy. An increase in the concentrations of intravenous anesthetics further increased her blood pressure. The blood pressure remained stable when anesthesia was maintained with sevoflurane and remifentanil after the interruption of propofol administration.
CONCLUSION
We concluded that propofol administration was the cause of increased blood pressure.
Core Tip: Although propofol generally reduces blood pressure, it has been known to rarely cause hypertension. However, studies on this mechanism and related case reports are rare. We report a case of uncontrolled hypertension in a 46-year-old woman with no medical history who was administered total intravenous anesthesia with propofol and remifentanil. In our study, other factors that could cause an increase in blood pressure were excluded, and we concluded that propofol was the cause of hypertension. This is a rare, but useful, case for the anesthetic management of propofol-induced hypertension.
