Systemic blood pressure variations during anesthesia Essay Submitted for partial fulfillment of master degree in anesthesia
EmanNassim Ahmed Abd El Fattah;
Abstract
Understanding the physiological basis of the blood pressure control is the primary essential step for the anesthesiologists involved in the care of patients with variable blood pressure.
Hypertension incidence is high in Egypt, so it is very important for us to know well how to manage it.The causes of hypertension with anesthesia areprimary hypertension, secondary hypertension and pregnancy induced hypertension. Anesthesia related causes include tracheal intubation, light anesthesia, drug overdose, malignant hyperthermia and aortic cross-clamping.
Hypotension may occur with general anesthesia and regionalanesthesiaincluding spinal, epidural and brachial plexus block. There are non anesthesia related causes like hypovolemia or endocrinal diseases.
Many guidelines have been established for the management of perioperative hypertension. However, most of them are based on experience only and further evidence basedrecommendations are required. Understanding the pharmacology of antihypertensive drugs is one essential step for the management.
Adequate monitoring of patients with variable pressure allows successful management.
Intraoperative acute blood pressure elevations of over 20% during surgery are considered a hypertensive emergency, and chronic hypertensive patients are more likely to have labile haemodynamics during a procedure. Adequate management is required to avoid cerebrovascular, renal and retinal complications.
Intraoperative management of hypotension is achieved through good choice of anesthesia, fluid administration and vasopressors. Especial care should be paid to regional anesthesia with caesarian section.
Hemostatic resuscitation is done to patients rapidly transported to the operating theatre or in patients with incompressible hemorrhage.
Postoperative hypertension should be avoided and/or managed in all patients, especially those with cardiovascular surgery,neurosurgery or major neck surgeries.
Postoperative hypotension is classified into hypovolemic, distributive and cardiogenic, each of which is managed accordingly.
Hypertension incidence is high in Egypt, so it is very important for us to know well how to manage it.The causes of hypertension with anesthesia areprimary hypertension, secondary hypertension and pregnancy induced hypertension. Anesthesia related causes include tracheal intubation, light anesthesia, drug overdose, malignant hyperthermia and aortic cross-clamping.
Hypotension may occur with general anesthesia and regionalanesthesiaincluding spinal, epidural and brachial plexus block. There are non anesthesia related causes like hypovolemia or endocrinal diseases.
Many guidelines have been established for the management of perioperative hypertension. However, most of them are based on experience only and further evidence basedrecommendations are required. Understanding the pharmacology of antihypertensive drugs is one essential step for the management.
Adequate monitoring of patients with variable pressure allows successful management.
Intraoperative acute blood pressure elevations of over 20% during surgery are considered a hypertensive emergency, and chronic hypertensive patients are more likely to have labile haemodynamics during a procedure. Adequate management is required to avoid cerebrovascular, renal and retinal complications.
Intraoperative management of hypotension is achieved through good choice of anesthesia, fluid administration and vasopressors. Especial care should be paid to regional anesthesia with caesarian section.
Hemostatic resuscitation is done to patients rapidly transported to the operating theatre or in patients with incompressible hemorrhage.
Postoperative hypertension should be avoided and/or managed in all patients, especially those with cardiovascular surgery,neurosurgery or major neck surgeries.
Postoperative hypotension is classified into hypovolemic, distributive and cardiogenic, each of which is managed accordingly.
Other data
| Title | Systemic blood pressure variations during anesthesia Essay Submitted for partial fulfillment of master degree in anesthesia | Other Titles | اختلاف ضغط الدم النظامي اثناء التخدير | Authors | EmanNassim Ahmed Abd El Fattah | Issue Date | 2015 |
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