Severe transient hypertension after greater palatine foramen block in a patient taking midodrine

Abstract We report an episode of transient, severe hypertension occurring within 2 minutes of injection of 1% lidocaine with 1:100 000 U of epinephrine in a patient taking midodrine for orthostatic hypotension. We hypothesize that the patient's autonomic nervous system was dangerously susceptib...

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Bibliographic Details
Published in:American journal of otolaryngology 2010, Vol.31 (1), p.67-69
Main Authors: Rizzi, Mark D., MD, Weil, Robert J., MD, Lorenz, Robert R., MD
Format: Article
Language:English
Subjects:
Anesthesia
Anesthesia, Local - adverse effects
Anesthetics, Local - adverse effects
Arterial hypertension. Arterial hypotension
Biological and medical sciences
Blood and lymphatic vessels
Blood pressure
Cardiology. Vascular system
Epinephrine - adverse effects
Heart attacks
Humans
Hypertension
Hypertension - chemically induced
Hypophysectomy
Lidocaine - adverse effects
Male
Medical sciences
Middle Aged
Midodrine - adverse effects
Otolaryngology
Otorhinolaryngology. Stomatology
Palatine Tonsil
Surgery
Tumors
Vasoconstrictor Agents - adverse effects
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Summary:Abstract We report an episode of transient, severe hypertension occurring within 2 minutes of injection of 1% lidocaine with 1:100 000 U of epinephrine in a patient taking midodrine for orthostatic hypotension. We hypothesize that the patient's autonomic nervous system was dangerously susceptible to the effect of local anesthetic when combined with the vasoactive systemic effect of midodrine. Surgeons should minimize the use of vasoconstrictors in patients treated with midodrine to avoid hypertensive complications.
ISSN:0196-0709
1532-818X
DOI:10.1016/j.amjoto.2008.09.007