© 2020 Lauren Reed
Anesthesia providers are frequently confronted by the problem of caring for patients presenting with sepsis in the operating room. Sepsis is associated with high healthcare costs and a significant mortality rate despite advancements in the understanding of its complicated pathophysiology. The 2016 Surviving Sepsis Campaign recommends norepinephrine as the first-choice vasopressor in septic patients. Its mild beta-adrenergic effects, in addition to its alpha-adrenergic effects, make it an attractive agent for the vasoplegia and myocardial dysfunction associated with sepsis. Earlier achievement of adequate perfusion pressures, earlier lactate clearance, and higher in-hospital survival have all been associated with norepinephrine use in the septic patient. However, it remains underutilized in the perioperative setting. Peripheral intravenous administration of norepinephrine has been associated with very low complication rates and norepinephrine, as an alternative to other vasopressors in patients undergoing general anesthesia, is showing promising results. In patients with sepsis requiring surgical source control, anesthesia providers should see themselves as key players in the critical care continuum and should be encouraged to consider the use of norepinephrine.
Reed, Lauren, "Norepinephrine Use In Septic Patients Undergoing General Anesthesia" (2020). Nurse Anesthesia Capstones. 32.