COME ON B.P.😲😲😲😲😲😲‼️

✔️The specific intraoperative situations in which induced arterial hypertension might be beneficial in Neuroanesthesia : 

(1) interventional neuroradiology (e.g.endovascular obliteration of cerebral aneurysms, cerebral angioplasty/stenting and intraarterial thrombolysis; 

(2) transient vessel occlusion during clipping of cerebral aneurysm and carotid endarterectomy

(3) extracranial to intracranial bypass surgery

(4) Surgery in patients with cerebral vasospasm after subarachnoid haemorrhage 

(5) In patients with a change in the cerebral autoregulation relationship, (e.g. intracranial pathology with mass effect, systemic hypertensive disease and traumatic brain injury.)

✔️Increase in BP is attained by vasoconstriction (rather than by increasing the cardiac output because changes in cardiac output do not affect CBF.)

✔️So intraoperatively alpha-agonist, phenylephrine is commonly used. 

✔️Others like dopamine, dobutamine and vasopressin can be used in the ICU.

#InducedHypertension , #NeuroAnaesthesia , #neurosurgery , #sah , #stroke , #anesthesia , #anaesthesia , #neurointensivecare , #criticalcare 

Reference:

Curr Opin Anesthesiol 2012, 25:548–555

Protecting the brain during neurosurgical procedures: strategies that can work, Hossam El Beheiry