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What Causes Sudden Dip In BP After Light Sedation And Fainting Spells?
Question: My blood pressure drops dramatically after even light sedation. Last procedure was a gastroscopy 10 minutes in duration, but BP was 82 over 40 on regaining consciousness and it took three hours for nurses to get it into what they termed "3 figures". I was kept in overnight, went to the toilet at 3 a.m. and blacked out. Came to on the bathroom floor. What causes this.
Brief Answer:
A comprehensive discussion about this issue is mandatory before anesthesia.
Detailed Answer:
Hello XXXX!
Thank you for asking on HCM!
I understand your concern, and would like to explain that your clinical scenario is compatible with an excessive hypotensive effect of sedative drugs.
It is well known that almost all sedative and hypnotic drugs exert such an effect. They may heighten a predisposition for a possible vaso-vagal response, as it seems to have happened at 3:00 a.m when on the bathroom.
At this point my recommendation is to avoid any antihypertensive therapy around such interventions (when sedation is required).
A satisfactory hydration, and a very meticulous blood pressure monitoring should be among the most important goals to achieve, when dealing with these situations.
I would recommend to be more selective when choosing the appropriate anesthetic drug, to avoid such an exaggerated reaction. Drugs with a safer hemodynamic profile could be a better choice, like etomidate, etc
You always have to talk with the surgical team about your specific profile (regarding sedative and hypnotic therapy), before the underlying procedure.
I also recommend you to perform electively a Head Up Tilt table test.
Hope to have been helpful to you.
Wishing you a good health! Greetings! Dr.Iliri
A comprehensive discussion about this issue is mandatory before anesthesia.
Detailed Answer:
Hello XXXX!
Thank you for asking on HCM!
I understand your concern, and would like to explain that your clinical scenario is compatible with an excessive hypotensive effect of sedative drugs.
It is well known that almost all sedative and hypnotic drugs exert such an effect. They may heighten a predisposition for a possible vaso-vagal response, as it seems to have happened at 3:00 a.m when on the bathroom.
At this point my recommendation is to avoid any antihypertensive therapy around such interventions (when sedation is required).
A satisfactory hydration, and a very meticulous blood pressure monitoring should be among the most important goals to achieve, when dealing with these situations.
I would recommend to be more selective when choosing the appropriate anesthetic drug, to avoid such an exaggerated reaction. Drugs with a safer hemodynamic profile could be a better choice, like etomidate, etc
You always have to talk with the surgical team about your specific profile (regarding sedative and hypnotic therapy), before the underlying procedure.
I also recommend you to perform electively a Head Up Tilt table test.
Hope to have been helpful to you.
Wishing you a good health! Greetings! Dr.Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Prasad
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