Why might controlled hypotension be used during surgery?

Why might controlled hypotension be used during surgery?

For half a century, controlled hypotension has been used to reduce bleeding and the need for blood transfusions, and provide a satisfactory bloodless surgical field.

What is controlled hypotension in anesthesia?

Controlled or deliberate hypotension is practitioner-initiated reduction of an anesthetized patient’s blood pressure (BP) to achieve a specific therapeutic purpose. The hypotensive state under hypotensive anesthetic sustains tissue perfusion with adequate blood flow.

How do you control intraoperative hypotension?

Ephedrine and phenylephrine Ephedrine is the first-line treatment of intraoperative hypotension during general anesthesia. Ephedrine is an indirect alpha and beta-adrenergic agonist, whereas phenylephrine is a direct alpha-agonist of the sympathetic system. These drugs have been well studied in the obstetrics setting.

What causes intraoperative hypotension?

The most common causes of intraoperative hypotension are anaesthetic drugs (including regional anaesthesia) and hypovolaemia. Initial management usually involves fluid bolus to optimise preload, and use of drugs to increase contractility and provide vasoconstriction.

Why is hypotensive Anaesthetic?

Controlled hypotension during anesthesia or hypotensive anesthesia is often used in major maxillofacial operations. Since hypotensive anesthesia carries the risk of hypoperfusion to important organs and tissues, mainly the brain, heart, and kidneys, it cannot be applied safely in all patients.

When is hypotensive anesthesia used?

Hypotensive anesthesia is considered to be a suitable anesthetic technique for those patients who will be undergoing spinal surgery, hip or knee arthroplasty, craniosynostosis, hepatic resections, robotic surgery, and major maxillofacial operations [6–11].

What is deliberate hypotension?

Deliberate hypotension refers to any technique that decreases a person’s blood pressure during surgery, to reduce bleeding and the need for allogeneic transfusion, and improves the surgical field.

Why is ephedrine given during surgery?

EPHEDRINE (e FED rin) injection is used to treat low blood pressure in patients who received certain types of anesthesia, underwent a specific type of surgery, or received an overdose of a drug that can lower blood pressure.

How do they monitor blood pressure during surgery?

Instruments commonly used for monitoring during anesthesia include: An inflatable blood pressure cuff. This is usually strapped around your upper arm. A pulse oximeter, a small instrument that is attached to your finger, toe, or earlobe to measure the level of oxygen in your blood.

Can local anesthesia cause low blood pressure?

Local anesthesia may induce systemic complications leading to parasympathetic activity leading to bradycardia and hypotension.

Can anesthesia cause high blood pressure?

Anesthesia. Undergoing anesthesia can have an effect on your blood pressure. Experts note that the upper airways of some people are sensitive to the placement of a breathing tube. This can activate the heart rate and temporarily increase blood pressure.

Does early warning system reduce intraoperative hypotension in noncardiac surgery?

Conclusions and relevance: In this single-center preliminary study of patients undergoing elective noncardiac surgery, the use of a machine learning-derived early warning system compared with standard care resulted in less intraoperative hypotension.

Does intraoperative hypotension play a role in the development of stroke?

Intraoperative hypotension might play a role in the development of postoperative ischemic stroke. Especially for mean blood pressure values decreasing more than 30% from baseline blood pressure, an association with postoperative ischemic stroke risks was observed.

What is intraoperative hypotension in general anaesthesia?

Intraoperative hypotension is a common side-effect of general anaesthesia that has received much attention in recent years because of its frequent occurrence and presumed adverse consequences. However, no widely accepted definition of intraoperative hypotension is available.

Can machine learning predict intraoperative hypotension?

DOI: 10.1001/jama.2020.0592 Abstract Importance: Intraoperative hypotension is associated with increased morbidity and mortality. A machine learning-derived early warning system to predict hypotension shortly before it occurs has been developed and validated.