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The Association Between Preoperative Tamsulosin Use and Intraoperative Hypotension
Christopher J Plambeck1, Julie K Freed2, Bethany Canales3
1Department of Anesthesiology, Cardiac Anesthesiology, Medical College of Wisconsin, Milwaukee, WI.
Journal of Cardiothoracic and Vascular Anesthesia
|January 20, 2026
Summary
Preoperative tamsulosin use in male patients undergoing cardiac surgery is linked to increased vasopressor needs during cardiopulmonary bypass (CPB) and after intensive care unit (ICU) admission. This finding highlights potential risks associated with tamsulosin before major cardiac procedures.
Area of Science:
- Cardiovascular Surgery
- Anesthesiology
- Pharmacology
Background:
- Tamsulosin, an alpha-1 blocker, is commonly prescribed for benign prostatic hyperplasia.
- Its potential effects on hemodynamic stability during major surgeries are not fully understood.
Purpose of the Study:
- To investigate the association between preoperative tamsulosin use and hypotension during cardiopulmonary bypass (CPB).
Main Methods:
- Retrospective observational cohort study.
- 159 male patients (40-90 years) undergoing coronary artery bypass graft or valve replacement surgery.
- Comparison of vasopressor use between patients taking tamsulosin preoperatively and those who were not.
Main Results:
- Tamsulosin users required significantly greater vasopressor support during all CPB time periods and upon ICU arrival.
- This association persisted after adjusting for risk factors for vasoplegia.
- Statistical significance was observed across multiple time points (p ≤ 0.033).
Conclusions:
- Preoperative tamsulosin use is associated with increased need for vasoactive support during CPB and post-ICU admission.
- Further prospective studies are recommended to confirm these findings and guide clinical practice.
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