| The Effect of Induced Hypotension on Intraoperative Blood Loss during Spinal Surgery. |
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Chang Kil Park |
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Department of Anesthesiology, Eulji University School of Medicine, Taejon, Korea. |
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| Abstract |
BACKGROUND
This study was performed to evaluate whether the degree of hypotension influences blood loss during spinal surgery.
METHOD
Fifty patients undergoing only one level spinal fusion were assigned to one of three groups. In group 1 (n = 14), the systolic blood pressure (SBP) was maintained at 100 120 mmHg with enflurane. In groups 2 (n = 18) and 3 (n = 18), the SBP were maintained at 80 100 and 60 80 mmHg, respectively. Hydralazine and esmolol were used in the hypotensive groups.
RESULTS
Blood losses during operation in groups 2 (554 +/- 287 ml) and 3 (456 +/- 162 ml) were significantly lower than in group 1 (1141 +/- 690 ml) (P < 0.05), although there was no significant difference between groups 2 and 3. The percentage of patients receiving transfusions during the operation in groups 1 and 2 were 57.1 and 5.6%, respectively.
CONCLUSIONS
The results show that a moderate reduction in SBP (80 - 100 mmHg) reduces blood loss by more than half in comparison to a mild reduction in SBP (100 - 120 mmHg).
However, a severe reduction in SBP (60 - 80 mmHg) does not increase the reduction in blood loss in comparison to moderate hypotension. |
| Key Words:
Anesthetic technique: induced hypotension; Hemorrhage: blood loss; Pharmacology: esmolol; hydralazine |
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