In older or cardiovascular-risk patients, have a vasopressor such as phenylephrine or norepinephrine drawn up, labelled and connected before induction. Titrate the induction dose to effect rather than giving a weight-based bolus. Post-induction hypotension is expected in these patients, and a ready vasopressor treats it in seconds.
- Prepare and label a vasopressor before induction in at-risk patients.
- Titrate the induction agent slowly in older and frail patients.
- Measure blood pressure every one to two minutes in the first ten minutes after induction.
Why it matters
The minutes after induction are when hypotension is most common and most easily treated.
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