Propofol-induced transient arginine vasopressin deficiency
Michael D Luppino1, Huyen Nguyen2, Matilda Smale2
1Flinders University, Bedford Park, South Australia, Australia.
Endocrinology, Diabetes & Metabolism Case Reports
|October 30, 2024
Summary
Propofol anesthesia can cause temporary arginine vasopressin deficiency (AVP-D), also known as central diabetes insipidus (DI). This case highlights the importance of monitoring fluid balance during anesthesia and recognizing AVP-D as a potential complication.
Area of Science:
- Anesthesiology
- Endocrinology
- Neurosurgery
Background:
- Anesthetic agents can rarely cause transient arginine vasopressin deficiency (AVP-D) or resistance (AVP-R).
- Propofol has been linked to AVP-D, while sevoflurane is associated with AVP-R, though differentiation can be challenging.
Purpose of the Study:
- To characterize a case of profound, transient AVP-D in a patient undergoing surgery.
- To investigate the association between anesthetic agents and AVP-D using serial measurements.
Main Methods:
- Case report of a 26-year-old female with sinonasal rhabdomyosarcoma.
- Serial copeptin and paired urine/serum osmolality measurements.
- Literature review of anesthesia-associated DI.
Main Results:
- The patient developed profound, transient AVP-D during propofol anesthesia.
- Measurements confirmed AVP-D, which resolved upon discontinuation of propofol.
- Literature supports propofol as a potential cause of anesthesia-associated AVP-D.
Conclusions:
- Propofol is a potential cause of anesthesia-induced AVP-D.
- Monitoring fluid balance and recognizing AVP-D are crucial during anesthesia.
- Switching anesthetic agents may rapidly resolve AVP-D/AVP-R.
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