• Emilie Stokholm Bækgaard, Bennedikte Kollerup Madsen, Vera Crone, Hayan El-Hallak, MøllerMorten HylanderMHDepartment of Intensive Care, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark., Morten Vester-Andersen, and Mette Krag.
• Department of Anaesthesiology and Intensive Care, Holbæk Hospital, Holbæk, Denmark.
• Acta Anaesthesiol Scand. 2024 Oct 1; 68 (9): 113411481134-1148.

BackgroundPerioperative hypotension is common and associated with adverse patient outcomes. Vasoactive agents are often used to manage hypotension, but the ideal drug, dose and duration of treatment has not been established. With this scoping review, we aim to provide an overview of the current body of evidence regarding the vasoactive agents used to treat perioperative hypotension in non-cardiac surgery.MethodsWe included all studies describing the use of vasoactive agents for the treatment of perioperative hypotension in non-cardiac surgery. We excluded literature reviews, case studies, and studies on animals and healthy subjects. We posed the following research questions: (1) in which surgical populations have vasoactive agents been studied? (2) which agents have been studied? (3) what doses have been assessed? (4) what is the duration of treatment? and (5) which desirable and undesirable outcomes have been assessed?ResultsWe included 124 studies representing 10 surgical specialties. Eighteen different agents were evaluated, predominantly phenylephrine, ephedrine, and noradrenaline. The agents were administered through six different routes, and numerous comparisons between agents, dosages and routes were included. Then, 88 distinct outcome measures were assessed, of which 54 were judged to be non-patient-centred.ConclusionsWe found that studies concerning vasoactive agents for the treatment of perioperative hypotension varied considerably in all aspects. Populations were heterogeneous, interventions and exposures included multiple agents compared against themselves, each other, fluids or placebo, and studies reported primarily non-patient-centred outcomes.© 2024 Acta Anaesthesiologica Scandinavica Foundation.

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