Uncontrolled high blood pressure under total intravenous anesthesia with propofol and remifentanil: A case report

Abstract

BACKGROUND

Although propofol generally reduces blood pressure, rarely, it causes hypertension. However, the mechanism by which propofol increases blood pressure has not been established, and so far, there are only a few reported cases.

CASE SUMMARY

A 46-year-old woman, diagnosed with thyroid cancer, was administered general anesthesia with propofol and remifentanil for a thyroid lobectomy. An increase in the concentrations of intravenous anesthetics further increased her blood pressure. The blood pressure remained stable when anesthesia was maintained with sevoflurane and remifentanil after the interruption of propofol administration.

CONCLUSION

We concluded that propofol administration was the cause of increased blood pressure.

Keywords: Anesthesia; Intravenous; Hypertension; Propofol; Remifentanil; Tachycardia; Case report

Core Tip: Although propofol generally reduces blood pressure, it has been known to rarely cause hypertension. However, studies on this mechanism and related case reports are rare. We report a case of uncontrolled hypertension in a 46-year-old woman with no medical history who was administered total intravenous anesthesia with propofol and remifentanil. In our study, other factors that could cause an increase in blood pressure were excluded, and we concluded that propofol was the cause of hypertension. This is a rare, but useful, case for the anesthetic management of propofol-induced hypertension.