Phenylephrine or Ephedrine for Intraoperative Hypotension? Consider the Cerebral Microcirculation

Editorial| November 2021 Phenylephrine or Ephedrine for Intraoperative Hypotension? Consider the Cerebral Microcirculation Paul S. García, M.D., Ph.D.; Paul S. García, M.D., Ph.D. From the Department of Anesthesiology, Neuroanesthesia Division, Columbia University Irving Medical Center, New York, New York; NewYork-Presbyterian Hospital, New York, New York Search for other works by this author on: This Site PubMed Google Scholar Charles H. Brown, IV, M.D., M.H.S. Charles H. Brown, IV, M.D., M.H.S. Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Hospital, Baltimore, Maryland Search for other works by this author on: This Site PubMed Google Scholar Author and Article Information This editorial accompanies the article on p. 788. Accepted for publication August 12, 2021. Address correspondence to Dr. García: Anesthesiology November 2021, Vol. 135, 775–777. https://doi.org/10.1097/ALN.0000000000003975 Connected Content Article: Cerebral Macro- and Microcirculation during Ephedrine versus Phenylephrine Treatment in Anesthetized Brain Tumor Patients: A Randomized Clinical Trial Using Magnetic Resonance Imaging Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Cite Icon Cite Get Permissions Search Site Citation Paul S. García, Charles H. Brown; Phenylephrine or Ephedrine for Intraoperative Hypotension? Consider the Cerebral Microcirculation. Anesthesiology 2021; 135:775–777 doi: https://doi.org/10.1097/ALN.0000000000003975 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu nav search search input Search input auto suggest search filter All ContentAll PublicationsAnesthesiology Search Advanced Search Topics: brain, ephedrine, intraoperative hypotension, microcirculation, phenylephrine Intraoperative hypotension is common and known to be associated with suboptimal patient outcomes.1 Over 90% of patients receiving anesthesia for surgery are expected to have at least one documented episode where the blood pressure decreased more than 20% below baseline.2 Although several factors may be involved in choosing a pharmacologic intervention for intraoperative hypotension in the absence of arrythmia (e.g., volume status, clinical effect of induction and maintenance anesthetics, anticipation of intense surgical stimulation), vasopressor support is often chosen as an efficient and convenient way to raise the blood pressure. In this issue, Koch et al. present a randomized controlled trial that compares the effects of our two most common agents for vasopressor support, phenylephrine and ephedrine, on characteristics of macro- and microcirculation.3 In this study, anesthetized brain tumor patients were randomly assigned to receive ephedrine or phenylephrine infusions while receiving magnetic resonance imaging pre-... You do not currently have access to this content.