Disadvantages of sedating neurologic patient
The long term end-organ effects add to patient morbidity and mortality.
Ensuring cardiovascular stability and pre-optimization of BP allows safe manipulation of physiology and pharmacology during anaesthesia.
Perioperative hypertension commonly occurs in patients undergoing surgery.
Accurate adjustment of treatment and monitoring of patient’s response to therapy are essential to safe and effective management of perioperative hypertension.
Many causes are involved in severe elevation of blood pressure; inadequate treatment of hypertension, renal diseases, head trauma and pre-eclampsia.
Intraoperative hypertension is also common and has many causes.
Emergency, anaesthesia, intensive care and surgery are among the clinical settings where proper recognition and management of acute hypertensive episodes is of great importance.
The greatest challenge is the acute care setting where the need for proper and sustained control of BP exists.Other common causes are autonomic hyperactivity, collagen-vascular diseases, drug use (stimulants, e.g.amphetamines and cocaine), glomerulonephritis, head trauma, pre-eclampsia and eclampsia, and renovascular hypertension.Signs and symptoms of hypertensive crisisinclude severe chest pain, severe headache accompanied by confusion and blurred vision, nausea and vomiting, severe anxiety, shortness of breath, seizures and unresponsiveness.Pathogenesis Humoral vasoconstrictors released in the hypertensive crises episodes result in a sudden increase in systemic vascular resistance.
Intraoperative hypertension is associated with acute pain induced sympathetic stimulation besides certain types of surgical procedures like carotid surgery, intrathoracic surgery and abdominal aortic surgery.