Table 2 Treatment for hemodynamic disturbances
Hemodynamic Fluctuation | Definition (if any of the below changes are sustained for equal and/or longer than 5 min) | Standard Treatment Algorithm |
|---|---|---|
Hypertension Episode | MAP > 20% above preoperative baseline | Increase propofol or sevoflurane concentration according to BIS, increase remifentanil infusion rate, or administer 5mcg sufentanil; if correction still not achieved, nicardipine will be given as bolus and/or infusion |
Hypotension Episode | MAP < 20% below preoperative baseline | Decrease propofol or sevoflurane concentration according to BIS, give adequate volume loading; if correction still not achieved, vasoactive agent administration (dopamine, norepinephrine, or phenylephrine) will be given with the dose and infusion rate adjusted according to the blood pressure response |
Tachycardia Episode | HR > 100 bpm | Esmolol bolus and/or infusion according to heart rate response |
Bradycardia Episode | HR < 45 bpm | Atropine administration |