Effect of Arginine Vasopressin on Intraoperative Hypotension Caused by Oral Administration of 5-Aminolevulinic Acid
5-Aminolevulinic acid (5-ALA) is used for the photodynamic diagnosis of malignant tumors and has been effectively utilized to improve the complete resection rate and reduce the risk of tumor recurrence. However, intraoperative hypotension is a common adverse effect of oral 5-ALA, and it occasionally...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Hindawi Limited
2023-01-01
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| Series: | Case Reports in Anesthesiology |
| Online Access: | http://dx.doi.org/10.1155/2023/1745373 |
| _version_ | 1797827847559053312 |
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| author | Gen Owada Hideo Nishizawa Yuki Matoyama Eri Watanabe Keigo Mitsuda Naoki Kaneko Yasuhiro Kimura Taikan Nanao Junichi Fujimoto |
| author_facet | Gen Owada Hideo Nishizawa Yuki Matoyama Eri Watanabe Keigo Mitsuda Naoki Kaneko Yasuhiro Kimura Taikan Nanao Junichi Fujimoto |
| author_sort | Gen Owada |
| collection | DOAJ |
| description | 5-Aminolevulinic acid (5-ALA) is used for the photodynamic diagnosis of malignant tumors and has been effectively utilized to improve the complete resection rate and reduce the risk of tumor recurrence. However, intraoperative hypotension is a common adverse effect of oral 5-ALA, and it occasionally progresses to severe prolonged hypotension requiring high-dose catecholamine administration. We report a case of intraoperative hypotension due to oral 5-ALA in which arginine vasopressin (AVP) administration was effective for increasing the blood pressure. A 77-year-old man scheduled for a craniotomy for glioma was administered 5-ALA orally before surgery. After the induction of anesthesia, his blood pressure decreased substantially. Although we administered various vasopressor agents, hypotension was prolonged. However, after starting a continuous administration of AVP, the systolic blood pressure increased, and the hemodynamic parameters remained stable during the remainder of the operation. 5-ALA administration may lower blood pressure by inducing nitric oxide production, and AVP inhibits inducible nitric oxide synthase messenger RNA expression and interleukin-1β-stimulated nitric oxide production. In light of these mechanisms, AVP may be a reasonable treatment agent for hypotension induced by 5-ALA. |
| first_indexed | 2024-04-09T12:54:55Z |
| format | Article |
| id | doaj.art-7f5abf620624482eb5304fcce08cdfe3 |
| institution | Directory Open Access Journal |
| issn | 2090-6390 |
| language | English |
| last_indexed | 2024-04-09T12:54:55Z |
| publishDate | 2023-01-01 |
| publisher | Hindawi Limited |
| record_format | Article |
| series | Case Reports in Anesthesiology |
| spelling | doaj.art-7f5abf620624482eb5304fcce08cdfe32023-05-14T00:00:01ZengHindawi LimitedCase Reports in Anesthesiology2090-63902023-01-01202310.1155/2023/1745373Effect of Arginine Vasopressin on Intraoperative Hypotension Caused by Oral Administration of 5-Aminolevulinic AcidGen Owada0Hideo Nishizawa1Yuki Matoyama2Eri Watanabe3Keigo Mitsuda4Naoki Kaneko5Yasuhiro Kimura6Taikan Nanao7Junichi Fujimoto8Department of Intensive Care MedicineDepartment of Intensive Care MedicineDepartment of Intensive Care MedicineDepartment of Intensive Care MedicineDepartment of AnesthesiaDepartment of Intensive Care MedicineDepartment of Intensive Care MedicineDepartment of Intensive Care MedicineDepartment of Intensive Care Medicine5-Aminolevulinic acid (5-ALA) is used for the photodynamic diagnosis of malignant tumors and has been effectively utilized to improve the complete resection rate and reduce the risk of tumor recurrence. However, intraoperative hypotension is a common adverse effect of oral 5-ALA, and it occasionally progresses to severe prolonged hypotension requiring high-dose catecholamine administration. We report a case of intraoperative hypotension due to oral 5-ALA in which arginine vasopressin (AVP) administration was effective for increasing the blood pressure. A 77-year-old man scheduled for a craniotomy for glioma was administered 5-ALA orally before surgery. After the induction of anesthesia, his blood pressure decreased substantially. Although we administered various vasopressor agents, hypotension was prolonged. However, after starting a continuous administration of AVP, the systolic blood pressure increased, and the hemodynamic parameters remained stable during the remainder of the operation. 5-ALA administration may lower blood pressure by inducing nitric oxide production, and AVP inhibits inducible nitric oxide synthase messenger RNA expression and interleukin-1β-stimulated nitric oxide production. In light of these mechanisms, AVP may be a reasonable treatment agent for hypotension induced by 5-ALA.http://dx.doi.org/10.1155/2023/1745373 |
| spellingShingle | Gen Owada Hideo Nishizawa Yuki Matoyama Eri Watanabe Keigo Mitsuda Naoki Kaneko Yasuhiro Kimura Taikan Nanao Junichi Fujimoto Effect of Arginine Vasopressin on Intraoperative Hypotension Caused by Oral Administration of 5-Aminolevulinic Acid Case Reports in Anesthesiology |
| title | Effect of Arginine Vasopressin on Intraoperative Hypotension Caused by Oral Administration of 5-Aminolevulinic Acid |
| title_full | Effect of Arginine Vasopressin on Intraoperative Hypotension Caused by Oral Administration of 5-Aminolevulinic Acid |
| title_fullStr | Effect of Arginine Vasopressin on Intraoperative Hypotension Caused by Oral Administration of 5-Aminolevulinic Acid |
| title_full_unstemmed | Effect of Arginine Vasopressin on Intraoperative Hypotension Caused by Oral Administration of 5-Aminolevulinic Acid |
| title_short | Effect of Arginine Vasopressin on Intraoperative Hypotension Caused by Oral Administration of 5-Aminolevulinic Acid |
| title_sort | effect of arginine vasopressin on intraoperative hypotension caused by oral administration of 5 aminolevulinic acid |
| url | http://dx.doi.org/10.1155/2023/1745373 |
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