Tamsulosin-induced severe hypotension during general anesthesia: a case report

Area of Science:

• Anesthesiology
• Pharmacology

Background:

• Tamsulosin is a selective α1-adrenergic receptor (α1-AR) antagonist, commonly prescribed for benign prostatic hypertrophy (BPH).
• Potential interactions between tamsulosin and anesthetic agents remain largely undescribed in clinical practice.

Purpose of the Study:

• To report a case of persistent hypotension in a patient receiving tamsulosin during general anesthesia.
• To highlight the potential for drug interactions between tamsulosin and anesthetic agents.

Main Methods:

• Case report of a 54-year-old male undergoing elective thyroid lobectomy.
• Patient was on tamsulosin 0.4 mg daily for BPH for one year.
• Hypotension occurred during the maintenance phase of anesthesia with isoflurane, oxygen, and nitrous oxide.

Main Results:

• The patient developed persistent hypotension during anesthesia.
• The hypotension was potentially linked to an interaction between isoflurane and tamsulosin.
• This case suggests a possible adverse drug interaction.

Conclusions:

• Surgical patients on selective α1-AR blockers like tamsulosin require vigilance for unexpected hypotension.
• Direct-acting adrenergic receptor agonists may be more effective vasopressors in managing hypotension in these patients.