Skip to main content

Table 2 Treatment for hemodynamic disturbances

From: Sevoflurane versus PRopofol combined with Remifentanil anesthesia Impact on postoperative Neurologic function in supratentorial Gliomas (SPRING): protocol for a randomized controlled trial

Hemodynamic Fluctuation


(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



HR > 100 bpm

Esmolol bolus and/or infusion according to heart rate response



HR < 45 bpm

Atropine administration

  1. MAP mean arterial pressure, HR heart rate, bpm beat per minute