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Anesthesia

Is Low Blood Pressure Normal After Surgery?

05/26/2006

Question:

I just had a hysterectomy. After surgery my pressure was very low. It was staying somewhere around 80something over 30something to 40something. My heart rate was high as well. The anesthesiologist kept giving me shots of neosenephrine, but all it did was increase my heart rate and did nothing for my pressure. I was in recovery dealing with this for about 6 hours. They pumped me up with fluids till the whites of my eyes were actually floating over my eyeballs! I have been told that this is fairly normal and no big deal. I was petrified.

Is this really normal? I’ve had general before and never experienced this. What can I do to ensure this doesn’t happen again? I’m afraid that if I ever need surgery again, I’ll totally panic over the possibility of going through this again. Thank you for any info.

Answer:

A blood pressure of 80/40 is definitely on the low end, however some individuals have blood pressure close to these values and are perfectly healthy. If your heart rate was high it does suggest that something out of the usual was going on.

There are many possible causes of low blood pressure after surgery. The most important ones include loss of blood, dehydration, heart problems, severe allergic reactions, the prolonged effect of anesthetic or pain medications, and acute infection.

The usual treatment of low blood pressure is to give intravenous fluids, oxygen, and medications that increase blood pressure. A commonly used medication to treat low blood pressure is phenylephrine, also known in the US as Neosynephrine. Neosynephrine does not usually increase the heart rate, in fact the opposite.

You did not mention whether you had a general anesthetic or a spinal or epidural. Low blood pressure is a pretty common side effect of epidural and spinal anesthesia. Your experience can hardly be considered "normal". However it is impossible to know exactly what happened based on the information you supplied.

You may want to explain your concern to surgeon and ask him or her to help you speak to the anesthesiologist, or at least someone from the anesthesiology department at the hospital. That doctor will be able to review the anesthetic record and the other medical records to help identify what happened and help you understand what happened, as well as to set your mind at ease about any future operations. Keep in mind that under US law you have the right to see your medical records, and you might even want to get a copy of them to show the anesthesiologist in case of any future hospitalizations.

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Response by:

Gareth S Kantor, MD Gareth S Kantor, MD
Assistant Professor of Anesthesiology
School of Medicine
Case Western Reserve University