The Organised Kat

01/07/2026

Wednesday 1st July was a busy day for me at work.

We had 2 new admissions, plus a patient from the previous day who was unfortunately still struggling with post-operative hypotension

Hypotension is quite a common perioperative complication. It can range from mild, asymptomatic low blood pressure, where they can still maintain perfusion to vital organs, all the way through to severe cardiovascular instability

We monitor a patient's response to their low blood pressure by frequently checking how they're feeling - dizziness or lightheadness, syncope, and confusion are signs that their blood pressure isn't high enough to adequately perfuse their brains. We also monitor their urine output, and their observations. We often use arterial lines to monitor invasive blood pressure if they are unstable.

Treatment can range from simply observing - many patient's will sort their own blood pressure given time, and this is what we tend to do with mild, asymptomatic hypotension. Sometimes we give IV fluid, especially if we suspect dehydration or blood loss is the cause. If we believe a patient is normovolaemic, and they have severe and/or symptomatic low blood pressure, we treat them with medications such as metaraminol.

Low blood pressure can cause organ damage, such as an AKI. It can also really impact patient's recovery by limiting their ability to mobilise.