• The incidence of serious falls in blood pressure and slowing of heart rate was studied in 40 unselected patients who came to surgery with a history of having taken Rauwolfia for the treatment of hypertension. Sixteen developed hypotension and bradycardia and did not respond satisfactorily to vasopressor drugs such as phenylephrine.
Elective surgery can be done on patients who have been on Rauwolfia therapy if this drug can be withheld for two weeks before operation. Emergency surgery on these patients can be carried out by using vagal blocking drugs such as atropine sulfate, scopolamine, or oxyphenonium to prevent and treat vagal circulatory responses.
Coakley CS, Alpert S, Boling JS. CIRCULATORY RESPONSES DURING ANESTHESIA OF PATIENTS ON RAUWOLFIA THERAPY. JAMA. 1956;161(12):1143–1144. doi:10.1001/jama.1956.02970120025007