looking for opinions - let's say you have a pt. on beta blockers. they come in for surgery and their HR is in the 60's-70's (which is their baseline) and their pressure is in the 70's/40's range. you've given fluid, blah, blah blah. my question is, which would be more appropriate for a pt on beta blockers to get, ephedrine or neosynephrine - to increase their bp? neo is of course a direct alpha agonist, so you have that going for you. ephedrine has some alpha action as well as beta action which would compete with the beta blockers for sites and reduce their effect, yada, yada, yada. any opinions?
Neo is what I would use as well, one thing, it just seems that giving just ephedrine never brings the pressure up good by itself when they are beta blocked----I also sometimes give 50-100 mcg of Neo and at the same time give 5-10 mg of Ephedrine
plus, they are beta blocked for a reason and that reason is to protect the heart-----so I would be cautious with getting the heart rate up too fast anyway---that is why I sometimes like a little of both because your heart rate usually remains about the same (without a big increase or big drop) and with the Neo, the BP is increased dramatically, which is what you want if it is 70/40
Last edit by jdpete on Sep 23, '05