RAPID RESPONSE FROM BMJ.COM: Hypotension, not hypertension, is a common side effect of  anesthetics

doi:10.1136/bmjusa.01070004

BMJ 2003;327:E51 (4 October), doi:10.1136/bmjusa.01070004 (published 5 September 2002)

BMJ USA: Letter

RAPID RESPONSE FROM BMJ.COM

Hypotension, not hypertension, is a common side effect of anesthetics

This article originally appeared in BMJ USA

Editor—In their interesting article, O'Rorke and Richardsonlisted local and general anesthetics as one of the antagoniststhat can increase blood pressure. Most anesthetic agents reduceboth systemic vascular resistance and myocardial contractility.¹ Relative anesthetic overdosing can cause significant hypotension, especially in hypovolemic and elderly patients.

However, during general anesthesia, hypertension can occur asa complication, due to:

Undiagnosed or poorly controlled preoperative high blood pressure;
Increased sympathetic tone secondary to inadequate analgesiaor anesthesia, hypoxemia, or hypercapnia;
Drug overdose (eg,epinephrine, ephedrine, ketamine, or ergometrine); and
Othercauses such as hypervolemia, aortic cross-clamping, pheochromocytoma,and malignant hyperthermia.

Every practicing anesthesiologist is aware that hypotension,not hypertension, is a common side effect of local or generalanesthetics.

MS Abdalla, specialist registrar in anesthetics

Petersborough District Hospital, Petersborough, UK ms.abdalla{at}anaesthetist.com

References

Hobbs G. Complications during anaesthesia. In: Aitkenhead AR, Smith, G, eds. Textbook of anaesthesia, 3rd ed. Edinburgh: Churchill Livingstone, 1996:380-382