Editorial  |   September 2020
Of Railroads and Roller Coasters: Considerations for Perioperative Blood Pressure Management?
Author Notes
  • From the Population Health Research Institute, Perioperative Medicine and Surgical Research Unit, Departments of Anesthesia and Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada (Y.L.M.); Department of Anaesthesia and Intensive Care, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Denmark (C.S.M.); Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom (G.S.C.); Department of Anaesthesia, Center for Cancer and Organ Diseases, Rigshospitalet, University of Copenhagen, Denmark (E.K.A.); and Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, CA (M.J.L.); San Francisco Veterans Affairs Medical Center, San Francisco, CA (M.J.L.).
  • This editorial accompanies the article on p. 510.
    This editorial accompanies the article on p. 510.×
  • Y.L.M. and C.S.M. contributed equally to this work.
    Y.L.M. and C.S.M. contributed equally to this work.×
  • Accepted for publication June 5, 2020. Published online first on July 24, 2020.
    Accepted for publication June 5, 2020. Published online first on July 24, 2020.×
  • Address correspondence to Dr. London: Martin.london@ucsf.edu
Article Information
Editorial / Cardiovascular Anesthesia
Editorial   |   September 2020
Of Railroads and Roller Coasters: Considerations for Perioperative Blood Pressure Management?
Anesthesiology 9 2020, Vol.133, 489-492. doi:https://doi.org/10.1097/ALN.0000000000003446
Anesthesiology 9 2020, Vol.133, 489-492. doi:https://doi.org/10.1097/ALN.0000000000003446
Management of intra- and early postoperative hemodynamics is the “bread and butter” of the operative anesthesiologist’s toolkit, a skill that gives many of us great pride. Who hasn’t rejoiced at the end of a long case to think to themselves, or better yet to brag to the surgeon, the recovery room nurse, or even a colleague, that the hemodynamics were “railroad tracks” all the way through? On the flip side, how many of us have gone home exhausted after a long case “battling” the “roller coaster” of blood pressure and/or heart rate? Although heart rate has been the subject of great controversy during the 1980s through early 2000s during the peak period of the beta blocker controversy, blood pressure has now assumed the forefront of this scrutiny. The pioneering work of many groups, applying rigorous techniques to the capture and analysis of large amounts of data downloaded from monitoring equipment, has provided numerous observational cohort analyses relating intra-, and more recently, early postoperative data to a variety of clinically important outcomes.