Anesth Pain Med.  2019 Oct;14(4):460-464. 10.17085/apm.2019.14.4.460.

Use of methylene blue in vasoplegic syndrome that developed during non-cardiac surgery: A case report

• Oh ID
• Shin E
• Jeon JM
• Woo H
• Choi JH

• KMID: 2465346
• DOI: http://doi.org/10.17085/apm.2019.14.4.460

Abstract

BACKGROUND
Vasoplegic syndrome is an increasingly recognized disease in perioperative medicine and is characterized by severe hypotension, normal or elevated cardiac output, and decreased systemic vascular resistance. It occurs commonly after cardiopulmonary bypass but may also occur after other types of surgery. CASE: Vasoplegic syndrome developed in our patient during posterior lumbar interbody fusion because of administering nicardipine after phenylephrine. However, the blood pressure did not increase as expected despite simultaneous use of norepinephrine and vasopressin to increase the reduced systemic vascular resistance.
CONCLUSIONS
We present a case of vasoplegic syndrome that developed during posterior lumbar interbody fusion and was treated successfully with methylene blue.

Keyword

Methylene blue; Nicardipine; Vasoplegia

MeSH Terms

Blood Pressure
Cardiac Output
Cardiopulmonary Bypass
Humans
Hypotension
Methylene Blue*
Nicardipine
Norepinephrine
Phenylephrine
Vascular Resistance
Vasoplegia*
Vasopressins
Methylene Blue
Nicardipine
Norepinephrine
Phenylephrine
Vasopressins

Figure

• 

  Fig. 1 Mean arterial pressure and heart rate during anesthesia in the operating room. CI: cardiac index, HR: heart rate, MAP: mean arterial pressure, NE: norepinephrine, SVRI: systemic vascular resistance index, SVV: stroke volume variation, PACU: post-anesthesia care unit.

• 

  Fig. 2 Mean arterial pressure (MAP) and heart rate (HR) during the immediate postoperative period in the post-anesthesia care unit. NE: norepinephrine.

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