Anesthesia for adult patients with hypertension
- Robert B Schonberger, MD, MHS
Robert B Schonberger, MD, MHS
- Associate Professor of Anesthesiology
- Yale University School of Medicine
- Manuel L Fontes, MD
Manuel L Fontes, MD
- Professor of Anesthesiology
- Division Chief Cardiac Anesthesia
- Director of Clinical Research
- Yale University
- Angela Selzer, MD
Angela Selzer, MD
- Assistant Professor of Anesthesiology
- University of Colorado School of Medicine
- Section Editor
- Roberta Hines, MD
Roberta Hines, MD
- Editor-in-Chief — Anesthesiology
- Section Editor — Anesthesia with Comorbid Cardiovascular/Pulmonary Conditions
- Professor and Chair, Department of Anesthesiology
- Yale School of Medicine
- Deputy Editors
- Nancy A Nussmeier, MD, FAHA
Nancy A Nussmeier, MD, FAHA
- Deputy Editor — Anesthesiology
- Department of Anesthesia, Critical Care, and Pain Medicine
- Massachusetts General Hospital
- John P Forman, MD, MSc
John P Forman, MD, MSc
- Senior Deputy Editor — UpToDate
- Deputy Editor — Nephrology
- Assistant Professor of Medicine
- Harvard Medical School
Hypertension is a common preexisting diagnosis in surgical patients, reported by nearly one-third of adult patients presenting for noncardiac procedures and two-thirds of those undergoing coronary revascularization .
This topic will focus on the anesthetic management of patients with preexisting hypertension. Management of hypertension in the preoperative and postoperative periods and urgent or emergent treatment of severe hypertension are discussed in separate topics:To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- PREANESTHESIA CONSULTATION
- Perioperative risk assessment
- Determination of target blood pressure values
- Decisions regarding blood pressure monitoring
- Antihypertensive medication management
- Perioperative care coordination
- MANAGEMENT IN THE IMMEDIATE PREOPERATIVE PERIOD
- Administration of morning antihypertensive doses
- Reduction of preoperative anxiety and pain
- PREVENTION AND TREATMENT OF INTRAOPERATIVE HYPERTENSION
- Intraoperative hypertensive episodes: General concepts
- Causes and management of intraoperative hypertension
- - Laryngoscopy and endotracheal intubation
- - Surgical stimulation
- - Emergence and tracheal extubation
- - Hypoxemia and/or hypercarbia
- - Hypervolemia
- - Antihypertensive medication withdrawal
- - Other causes
- Management of hypertensive emergencies
- PREVENTION AND TREATMENT OF INTRAOPERATIVE HYPOTENSION
- Intraoperative hypotensive episodes: General concepts
- Causes and management of intraoperative hypotension
- - Hypovolemia
- - Induction of general anesthesia
- - Sympathectomy due to neuraxial block
- - Inhibition of the renin angiotensin system
- - Other causes
- MANAGEMENT IN THE IMMEDIATE POSTOPERATIVE PERIOD
- Acute postoperative hypertension
- - Initial assessment and treatment
- - Treatment of underlying causes
- - Reinstitution of antihypertensive medications
- Acute postoperative hypotension
- - Initial assessment and treatment
- - Treatment of underlying causes
- SUMMARY AND RECOMMENDATIONS