Unexplained Perioperative Hypotension in a Patient Treated with Pine Needle Extract

Heeseung Lee, Heehun Jeon, Jong In Han, Youn Jin Kim, Chi Hyo Kim, Dong Yeon Kim

Department of Anesthesiology and Pain Medicine, School of Medicine, Ewha Womans University, Seoul, South of Korea.

DOI: 10.4236/ojanes.2013.31003                

Abstract

Pine needle-based products are popular dietary supplements in East Asia for health promotion. Pine needle extract (PNE) are especially known as potential anti-hypertensive and anti-lipidemic agents. We report a case of profound, long-lasting unexplained hypotension during and after anesthesia in a patient treated with PNE. Bedside transthorasic echocardiography (TTE) was used as a part of useful diagnostic modality.

Keywords

Echocardiography; Hypotension; Pine Needle Extract

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	N. Y. Kim, M. K. Jang, D. G. Lee, K. H. Yu, H. J. Jang, M. Kim, S. G. Kim, B. H. Yoo and S. H. Lee, “Comparison of Methods for Proanthocyanidin Extraction from Pine (Pinus densiflora) Needles and Biological Activities of Extracts,” Nutrition Research and Practice, Vol. 4, No. 1, 2010, pp. 16-22. doi:10.4162/nrp.2010.4.1.16
[2]	K. Y. Kim and H. J. Chung, “Flavor Compounds of Pine Sprout Tea and Pine Needle Tea,” Journal of Agricultural and Food Chemistry, Vol. 48, No. 4, 2000, pp. 1269-1272. doi:10.1021/jf9900229
[3]	J. B. Jeong, E. W. Seo and H. J. Jeong, “Effects of Extracts of Pine Needle against Oxidative DNA Damage and Apoptosis Induced by Hydroxyl Radical via Antioxidant Activities,” Food and Chemical Toxicology, Vol. 47, No. 8, 2009, pp. 2135-2141. doi:10.1016/j.fct.2009.05.034
[4]	M. J. Jung, H. A. Jung, S. S. Kang, G. S. Hwang and J. S. Choi, “A New Abietic Acid-Type Diterpene Glucoside from the Needles of Pinus densiflora,” Archives of Phar acal Research, Vol. 32, No. 12, pp. 1699 1704.
[5]	J. H. Kwon, J. H. Kim, S. E. Choi, K. H. Park and M. W. Lee, “Inhibitory Effects of Phenolic Compounds from Needles of Pinus ensiflora on Nitric Oxide and PGE2 Production,” Archives of Pharmacal Research, Vol. 33, No. 12, 2010, pp. 2011-2016. doi:10.1007/s12272-010-1217-y
[6]	J. R. Jeon and J. Y. Kim, “Effects of Pine Needle Extract on Differentiation of 3T3-L1 Preadipocytes and Obesity in High-Fat Diet Fed Rats,” Biological & Pharmaceutical Bulletin, Vol. 29, No. 10, 2006, pp. 2111-2115. doi:10.1248/bpb.29.2111
[7]	S. P. Ford, L. K. Christenson, J. P. Rosazza and R. E. Short, “Effects of Ponderosa Pine Needle Ingestion on Uterine Vascular Function in Late-Gestation Beef Cows,” Journal of Animal Science, Vol. 70, No. 5, pp. 1609 1614.
[8]	F. C. Chow, K. J. Hanson, D. W. Hamer and R. H. Udall, “Reproductive Failure of Mice Caused by Pine Needle Ingestion,” Journal of Reproduction and Fertility, Vol. 30, No. 1, 1972, pp. 169-172. doi:10.1530/jrf.0.0300169
[9]	H. S. Cheong and D. Y. Lim, “Pine Needle Extracts Inhibit Contractile Responses of the Isolated Rat Aortic Stripes,” Natural Product Sciences, Vol. 16, No. 2, 2010, pp. 123-132.
[10]	B. Subramaniam and D. Talmor, “Echocardiography for Management of Hypotension in the Intensive Care Unit,” Critical Care Medicine, Vol. 35, No. 8, 2007, pp S401 S407. doi:10.1097/01.CCM.0000270277.29661.3B
[11]	B. S. Cowie, “Focused Transthorasic Echocardiography in the Perioperative Period,” Anaesth Intensive Care, Vol. 38, No. 5, 2010, pp. 823-836.