[Hypertension with tachycardia caused by propofol during induction of general anesthesia].

A 75-year-old man underwent elective posterior lumbar interbody fusion due to canal stenosis. Anesthesia was induced with fentanyl 100 microg, propofol 65 mg (0.95 mg x kg(-1)) and vecronium 7 mg. Bag and mask ventilation was easy and end-tidal sevoflurane reached 3% but arterial blood pressure (ABP) and heart rate (HR) increased to 180-200/90-110 mmHg and 90-110 beats x min(-1) respectively. Additional fentanyl 100 microg and propofol 70 mg were not effective. N2O was started and fentanyl 50 microg and landiolol 5 mg were administerd. Twenty-five minutes after initiation of anesthesia, ABP and HR decreased to 123/76 mmHg and 83 beats x min(-1), respectively. When right ureteral dilatation was undertaken due to obstruction on POD 7, thiamylal 300 mg for anesthetic induction did not increase ABP and HR. Hypertension with tachycardia during induction of general anesthesia can be usually caused by pain, hypoventilation, intracranial hemorrhage and myocardial ischemia etc but all of them were denied in this clinical course. Previous reports had shown that a small amount of propofol itself induced vasoconstriction and we concluded that a low dose of propofol to avoid hypotension during induction could cause hypertension with tachycardia.