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We sought to assess the relative contribution of various hemodynamic mechanisms to hypotension after induction of general anesthesia with sufentanil, propofol, and rocuronium. In this prospective observational study, we continuously recorded hemodynamic variables during anesthetic induction using a finger-cuff method in 92 non-cardiac surgery patients. After sufentanil administration, there was no clinically important change in arterial pressure, but heart rate increased from baseline by 11 (99.89% confidence interval: 7 to 16) bpm (P\u2009&lt;\u20090.001). After administration of propofol, mean arterial pressure decreased by 23 (17 to 28) mmHg and systemic vascular resistance index decreased by 565 (419 to 712) dyn*s*cm\n                    <jats:sup>\u22125<\/jats:sup>\n                    *m\n                    <jats:sup>2<\/jats:sup>\n                    (P values &lt;\u20090.001). Mean arterial pressure was &lt;\u200965\u00a0mmHg in 27 patients (29%). After propofol administration, heart rate returned to baseline, and stroke volume index and cardiac index remained stable. After tracheal intubation, there were no clinically important differences compared to baseline in heart rate, stroke volume index, and cardiac index, but arterial pressure and systemic vascular resistance index remained markedly decreased. Anesthetic induction with sufentanil, propofol, and rocuronium reduced\u00a0arterial pressure and systemic vascular resistance index. Heart rate, stroke volume index, and cardiac index remained stable. Post-induction hypotension therefore appears to result from arterial dilation with reduced systemic vascular resistance rather than venous dilation\u00a0or reduced myocardial contractility.\n                  <\/jats:p>","DOI":"10.1007\/s10877-021-00653-9","type":"journal-article","created":{"date-parts":[[2021,2,1]],"date-time":"2021-02-01T02:02:44Z","timestamp":1612144964000},"page":"341-347","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":128,"title":["Mechanisms contributing to hypotension after anesthetic induction with sufentanil, propofol, and rocuronium: a prospective observational study"],"prefix":"10.1007","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6619-0722","authenticated-orcid":false,"given":"Bernd","family":"Saugel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa-Johanna","family":"Bebert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luisa","family":"Briesenick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phillip","family":"Hoppe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gillis","family":"Greiwe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongsheng","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward J.","family":"Mascha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel I.","family":"Sessler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorothea E.","family":"Rogge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,2,1]]},"reference":[{"key":"653_CR1","doi-asserted-by":"publisher","first-page":"811","DOI":"10.1007\/s00134-018-5224-7","volume":"44","author":"DI Sessler","year":"2018","unstructured":"Sessler DI, Khanna AK. 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Bernd Saugel has received honoraria for consulting, honoraria for giving lectures, and refunds of travel expenses from Edwards Lifesciences Inc. (Irvine, CA, USA). Bernd Saugel has received honoraria for consulting, institutional restricted research grants, honoraria for giving lectures, and refunds of travel expenses from Pulsion Medical Systems SE (Feldkirchen, Germany). Bernd Saugel has received institutional restricted research grants from Retia Medical LLC. (Valhalla, NY, USA). Bernd Saugel has received honoraria for giving lectures from Philips Medizin Systeme B\u00f6blingen GmbH (B\u00f6blingen, Germany). Bernd Saugel has received honoraria for consulting, institutional restricted research grants, and refunds of travel expenses from Tensys Medical Inc. (San Diego, CA, USA). Daniel I. Sessler is a consultant for Edwards Lifesciences Inc\u00a0and Sensifree (Cupertino, CA, USA). The Department of Outcomes Research conducts research funded by Edwards Lifesciences Inc.. All other authors have no conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All patients provided written informed consent.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"All patients signed informed consent regarding publishing their data.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publish"}},{"value":"The study was approved by the Ethics Committee of the Medical Association of Hamburg, Hamburg, Germany (Chairperson Prof. R. Stahl) on January 9, 2018.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}