Epidurals and Blood pressure issues

Jul 15, 2008 07:21 PM

by heaverboo

Ive seen and also been told that epidurals with pain medications are known to drop the blood pressure? Why is this the case? Also I remember when I did my labor and delivery rotation they would give a 1000 ml bolus before anesthesia inserted the epidural. Any explanations?

*deeDawntee* · Jul 15, 2008, 07:30 PM

Re: Epidurals and Blood pressure issues

Epidurals relieve pain (obviously) so any hypertension caused by pain will be reversed and the pt's BP will return to baseline. Also, there is a relaxation of muscles, even those that line the vasculature and this will cause vasodilation and a drop in blood pressure. A bolus of IV fluids will increase intravascular volume and will compensate for the dilation.

Does that make sense?

heaverboo · Jul 16, 2008, 09:54 AM

Re: Epidurals and Blood pressure issues

Sort of...so it just causes dilation? We use epidurals alot on orthopedics for pain relief, sometimes they work for the patient and sometimes they dont. When patients have epidurals we have standing orders if the SBP drops <90 we can give a 500 ml NS bolus. Just wondering the true cause of the drop in BP with epidurals. Thanks for trying to explain.

SassyJennRN · Jul 21, 2008, 08:38 AM

Re: Epidurals and Blood pressure issues

Well I guess it depends whats running in your epi's... We use a combo of bipivucaine and fentanyl in ours. I have always been taught that it is the bipivucaine that makes the BP drop. Most of our docs have standing orders for epinephrine and fluid bolus when the systolic is below 90...and it commonly is.

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Epidurals and Blood pressure issues

Epidurals and Blood pressure issues

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