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Discussion

Holding benzos

How low of a blood pressure would cause you to hold a benzo such as Ativan or Librium?

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    It's never really as simple as just a number, so given your combination of medications I would guess you're talking about a patient in alcohol withdrawal. The withdrawal symptoms we're treating with benzos typically also drive up blood pressure, so if the patient is hypotensive then that usually also means additional benzos are not indicated. There are certainly exceptions, such as a patient who presents with sepsis and then also goes into withdrawal, in which case I would still treat withdrawal symptoms and prevent seizures with benzos, and then use pressors to treat the sepsis induced hypotension.

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    Totally agree with Muno...

    The MAP is more important than the actual BP numbers for perfusion, if it sustains below 60 pressors can bring it up. Holding benzos in withdrawal is more harmful than a low BP but it can be a dance.

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