Selecting a Vasopressor and Inotrope Drug in Perioperative Patients

Abstract

When considering circulatory management in perioperative patients, the first thing to do is provide adequate analgesia, as pain stimulation alters hemodynamics dramatically. If hemodynamics would be unstable and hypotensive even after controlling pain and optimizing blood circulation volume, the use of catecholamine for perioperative patients needs to be considered. Noradrenaline has some advantages compared to dopamine, and has therefore been recommended as a first choice vasopressor. Since cardiac dysfunction may occur in perioperative patients, transthoracic echocardiography should be used to confirm cardiac function in patients with unstable hemodynamics, especially those with poor fluid response. The use of dobutamine or PDE III inhibitors should be considered in patients with impaired cardiac function and poor response to noradrenaline and fluids.