As an SRNA I run in bradycardia quite a bit. I'm sure a big part of this is that (as staff) I do a lot of lap cases, hernia, and cases on young,healthy men.

I deal with extreme bradycardia (HR in the 30s or lower and/or low BP) but asking the surgeon to stop whatever they doing ("Please stop pulling, please let stop insuflating, etc") and, if necessary, give atropine.

For less emergent situations, I give 0.2mg of glyco and 10mg of ephedrine. The problem is that patients' responses to glyco seem (at least to me) to be quite varied and unpredictable. Lots of times the little bit of glyco will increase the HR into the 90s and the next thing I know I'm chasing my tail giving beta-blocker. Not a good anesthetic

As an primarily indirect vasopressor I assume that ephedrine's has a celing effect related to catecholine stores. However, (never afraid to show my own stupdidity), I figured I'd ask anyways:

What is the effect of high dose ephedrine. I.e. lets says 25mg+ of ephedrine? Will this be at all effective in treating severe, but transient bradycardia in the setting of hypotension?