Abstract
According to the World Health Organization, about 450 million people suffer from mental and behavioral disorders worldwide,[1] whereas depression has a lifetime prevalence between 10% and 20%.[2] Many surgical patients may take antidepressants, and several studies have reported an increased incidence of sudden cardiac death in these patients. We here present a patient who had major depression under medication control for 20 years and underwent left nephrectomy. Severe hypotension, resistant to catecholamine (such as ephedrine, epinephrine, and dopamine) treatment, was developed after general anesthetic induction. A review of preoperative psychotropic medications on patient's hemodynamic changes and the management for the refractory hypotension after general anesthetic induction are presented and discussed in this case report.
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