Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
5884413 | Journal of Clinical Anesthesia | 2016 | 4 Pages |
â¢Glucagon is a sphincter of Oddi relaxant and also an empiric treatment for β-blocker overdose.â¢Our patient experienced a hypertensive emergency due to acute β-blockade reversal.â¢Glucagon-induced crises have been observed in patients with asymptomatic pheochromocytoma.â¢Glucagon has potentially severe hemodynamic effects even in healthy populations.
Glucagon is well acknowledged as a sphincter of Oddi relaxant for both diagnostic and therapeutic uses in choledocholithiasis, and an empiric treatment for β-blocker overdose. Although it has been implicated in inducing cardiovascular crises in patients with asymptomatic pheochromocytoma, adverse effects in other patient populations have not been characterized. This case report describes a patient with hypertension controlled on β blockers who, after glucagon administration during an intraoperative cholangiography, experienced hypertensive emergency despite adequate pain control. Nitroglycerin acted as a key agent to decrease the patient's blood pressure as well as a secondary relaxant of the sphincter of Oddi. The patient had no radiographic evidence of pheochromocytoma. As out-of-operating room and intraoperative uses of glucagon continue to increase, perioperative physicians should be aware of its potential hemodynamic effects even in healthy populations.