What blood pressure cut-off (if any) are members using to decide to cancel a procedure? The question is posed due to possible steroid-induced or (very rare but possible) procedural pain in a non-sedated patient causing temporary blood pressure elevation which may theoretically lead to a cardiovascular event.
blood pressure cut-off for procedures
- Thread starter nwbgn
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Anesthesiology guidelines - there is an increased risk of perioperative complications in patients with systolic BP>=180 and diastolic >=110, but no evidence for increased risk below these levels.
OR a 20% increase over baseline blood pressure.
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I typically want the diastolic for sure to be <100
Systolic is varies.
Also, if I'm just doing a diagnostic MBB, there's no 'steroid induced increased BP" phenomenon that can occur. In fact, local anesthetic can decrease BP.
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However the needles you insert prior to anesthetic injection are MORE likely to greatly increase BP before you ever get a drop.
I believe the steroid induced mechanism is related to sodium channel or aldosterone effects which results in fluid retention; this can cause increased preload and afterload on the heart, as well as increase risk for pulmonary edema from fluid overload; I believe this kicks in a day or so later
some advocate using half-dose steroid in those at risk
If they are on lasix or diuretic, I make sure they take them that day. Perhaps dialysis timing for those with ESRD should be considered
some advocate using half-dose steroid in those at risk
If they are on lasix or diuretic, I make sure they take them that day. Perhaps dialysis timing for those with ESRD should be considered
