The Elephant In The Room - intraoperative hypotension. A discussion regarding the exciting results from the first multicentre, randomised controlled trial into targeted intraoperative blood pressure management. This conversation reflects the start of many debates and concern regarding hypotension, a frequent topic here on TopMedTalk. Monty Mythen and Mike Grocott are with Tim Miller, Duke University Medical Centre, speaking with their guest Dr Dan Sessler, Cleveland Clinic.