Hypertension, defined as a mean arterial pressure >120–140 mm Hg or a systolic arterial pressure >160–180mm Hg,44 is uncommon in the adequately anesthetized patient, even in patients with primary hypertension, because of the negative cardiovascular effects of inhalant anesthetics. Again, rule out a response to noxious stimulation, hypoxemia, hypercarbia, hypovolemia, and a light plane of anesthesia. The BP cuff should also be examined to ensure it has not slipped distally (e.g., around the carpus). BP can be verified with a second technique such as Doppler. Analgesics such as additional opioid should be provided to the patient who is consistently hypertensive. If hypertension persists but the patient appears to be adequately anesthetized and receiving appropriate analgesia, the increased BP may be tolerated. Increasing the vaporizer concentration in an attempt to decrease BP is not advised.