Anaesthetic-related acute hypotension

I95.81

Treat the cause of hypotension.

Ensure appropriate fluids are given to correct hypovolaemia.

The medicines given below all require significant dilution before administration.

  • Adrenergic and dopaminergic agents, e.g.:
  • Ephedrine IV, 3–5 mg as a single dose and then further boluses as required to a maximum of 30 mg.
    • Increases heart rate and contractility, and vasoconstrictor.
    • Repeated administration can result in tolerance and tachyphylaxis.
    • Alternative vasopressor infusion (e.g. adrenaline (epinephrine)) may be needed to mitigate unresponsiveness to treatment.

LoEIII [29]

OR

  • Phenylephrine IV, 50–100 mcg as a single dose and then infuse at 60–180 mcg/minute.
    • Vasoconstrictor.
    • High doses may cause significant reflex. bradycardia: treat this by discontinuing the phenylephrine only.

LoEIII [30]