Intra-anesthetic Problems - Hypertension
Etiologies
Etiologies
- Catecholamine excess may be seen with inadequate anesthesia, especially during laryngoscopy, intubation, incision, emergence, hypoxia, hypercarbia, patient anxiety, pain, and prolonged tourniquet use.
- Preexisting disease such as essential hypertension or pheochromocytoma.
- Increased intracranial pressure
- Systemic absorption of vasoconstrictors such as epinephrine and phenylephrine.
- Aortic cross-clamping which leads to a significant increase in SVR.
- Rebound hypertension from discontinuation of clonidine or β-adrenergic blockers.
- Drug interactions. The administration of ephedrine to patients receiving tricyclic antidepressants (e.g., amitriptyline, nortriptyline, doxepin) and monoamine oxidase inhibitors (e.g., isoniazid, rasagiline, selegiline) may cause an exaggerated hypertensive response.
- Bladder distention
- Administration of indigo carmine dye (via an α-adrenergic effect).
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Citation
Pino, Richard M., editor. "Intra-anesthetic Problems - Hypertension." Clinical Anesthesia Procedures, 9th ed., Wolters Kluwer, 2019. Anesthesia Central, anesth.unboundmedicine.com/anesthesia/view/ClinicalAnesthesiaProcedures/728242/all/Intra_anesthetic_Problems___Hypertension.
Intra-anesthetic Problems - Hypertension. In: Pino RMR, ed. Clinical Anesthesia Procedures. Wolters Kluwer; 2019. https://anesth.unboundmedicine.com/anesthesia/view/ClinicalAnesthesiaProcedures/728242/all/Intra_anesthetic_Problems___Hypertension. Accessed October 5, 2024.
Intra-anesthetic Problems - Hypertension. (2019). In Pino, R. M. (Ed.), Clinical Anesthesia Procedures (9th ed.). Wolters Kluwer. https://anesth.unboundmedicine.com/anesthesia/view/ClinicalAnesthesiaProcedures/728242/all/Intra_anesthetic_Problems___Hypertension
Intra-anesthetic Problems - Hypertension [Internet]. In: Pino RMR, editors. Clinical Anesthesia Procedures. Wolters Kluwer; 2019. [cited 2024 October 05]. Available from: https://anesth.unboundmedicine.com/anesthesia/view/ClinicalAnesthesiaProcedures/728242/all/Intra_anesthetic_Problems___Hypertension.
* Article titles in AMA citation format should be in sentence-case
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