Ephedrine to treat intraoperative hypotension in infants: what

Br J Anaesth · May 2023

Editorial Comment

Ephedrine to treat intraoperative hypotension in infants: what is the target?

Off-label use of medications in paediatric anaesthesia is common practice, owing to the relative paucity of evidence-based dosing regimens in children. Well-performed dose-finding studies, especially in infants, are rare and urgently needed. ⋯ We discuss the problems of off-label medication use and the lack of evidence for various definitions of hypotension and associated treatment strategies in paediatric anaesthesia. What is the aim of treating hypotension associated with anaesthesia induction: restoring the MAP to awake baseline values or elevating it above a provisional hypotension threshold?

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- Jurgen C de Graaff and Peter Frykholm.
- Department of Anaesthesiology, ADRZ-Erasmus MC, Goes, the Netherlands. Electronic address: j.degraaff@erasmusmc.nl.
- Br J Anaesth. 2023 May 1; 130 (5): 510515510-515.
AbstractOff-label use of medications in paediatric anaesthesia is common practice, owing to the relative paucity of evidence-based dosing regimens in children. Well-performed dose-finding studies, especially in infants, are rare and urgently needed. Unanticipated effects can result when paediatric dosing is based on adult parameters or local traditions. A recent dose-finding study on ephedrine highlights the uniqueness of paediatric dosing in comparison with adult dosing. We discuss the problems of off-label medication use and the lack of evidence for various definitions of hypotension and associated treatment strategies in paediatric anaesthesia. What is the aim of treating hypotension associated with anaesthesia induction: restoring the MAP to awake baseline values or elevating it above a provisional hypotension threshold?Copyright © 2023 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

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Ephedrine to treat intraoperative hypotension in infants: what is the target?

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