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doi:10.1136/bmjusa.01070004

BMJ, doi: 10.1136/bmjusa.01070004, (Published 5 September 2002)

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

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This article originally appeared in BMJ USA

EDITOR $---$ In their interesting article, O'Rorke and Richardson listed local and general anesthetics as one of the antagoniststhat can increase blood pressure. Most anesthetic agents reduceboth systemic vascular resistance and myocardial contractility.¹Relative anesthetic overdosing can cause significant hypotension,especially in hypovolemic and elderlypatients.

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

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

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@anaesthetist.com

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

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