Induced Hypotension

Petrozza, Patricia H.

doi:10.1097/00004311-199002840-00008

Cited by 26 publications

(11 citation statements)

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“…In the present study, MAP was maintained between 55 and 65 mmHg as outcome studies have demonstrated that a reduction of the mean arterial pressure (MAP) to 55-65 mmHg or a decrease of 30% from baseline is safe with regards to endorgan perfusion and oxygen delivery [35].…”

Section: Discussionmentioning

confidence: 88%

Cerebral oxygen saturation monitoring during hypotensive anesthesia in shoulder arthroscopy: A comparative study between dexmedetomidine and esmolol

Maghawry

Elagamy

Tahir

et al. 2015

Egyptian Journal of Anaesthesia

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Background: Beach chair position (BCP) is used in arthroscopic shoulder operations for its advantages. The BCP together with deliberate hypotension used to decrease intraoperative blood loss during arthroscopic shoulder procedures, this may have risk to cause postoperative neurological insults. Dexmedetomidine and esmolol are used to induce deliberate hypotension. Near-infrared spectroscopy (NIRS) provides a non-invasive technique of continuous monitoring of regional cerebral tissue oxygen saturation (rScO 2 ). In this study we evaluate the prevalence of rScO 2 during hypotensive anesthesia induced by intra-operative infusion of either dexmedetomidine or esmolol in patients undergoing elective arthroscopic shoulder surgery in the BCP. Patients and methods: Fifty patients scheduled for elective arthroscopic shoulder surgery under general anesthesia with hypotensive technique in BCP, randomly assigned into two equal groups, dexmedetomidine group (D Group) and esmolol group (E Group) according to the drug used for deliberate hypotension. MAP, HR, BIS and rS c O 2 were recorded before induction of anesthesia T 0 , post-induction of anesthesia T 1 as baseline, 5 min after BCP T 2 , 5 min after starting the studied drug T 3 , 30 min T 4 , 60 min T 5 , 90 min T 6 , 5 min after stopping the studied drug T 7 , 5 min after return to supine T 8 and after extubation T 9 . Results: In D group there was significant decrease in Lt.rs c o 2 and Rt.rs c o 2 , at T2 to T7 compared to T1. In E group there was significant decrease in Lt.rs c o 2 and Rt.rs c o 2 at T2, to T7 compared to T1. In D group two patients had CDEs compared to five patients in E group. Conclusion: In patients undergoing shoulder arthroscopic surgery under general anesthesia, the BCP significantly decreases rS c O 2 , with further slight decrease of rS c O 2 with dexmedetomidine and esmolol induced hypotension with no affection of postoperative cognitive function with both drugs. Dexmedetomidine and esmolol are safe drugs with better safety of dexmedetomidine over esmolol.

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Section: Discussionmentioning

confidence: 88%

Cerebral oxygen saturation monitoring during hypotensive anesthesia in shoulder arthroscopy: A comparative study between dexmedetomidine and esmolol

Maghawry

Elagamy

Tahir

et al. 2015

Egyptian Journal of Anaesthesia

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“…Intermittent positive pressure ventilation should be adjusted such that the airway pressures are kept to a minimum. Avoidance of the use of positive end expiratory pressure is also helpful via preventing higher intrathoracic pressure 9,24 .…”

Section: Maintenance Of Anaesthesia Depthmentioning

confidence: 99%

Anaesthetic Concerns for Functional Endoscopic Sinus Surgery

Tan

Poopalalingam

2014

Proceedings of Singapore Healthcare

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BACKGROUND Functional endoscopic sinus surgery provides a challenge and an opportunity for the anaesthesiologists to provide surgeons with a surgical field, which can make this delicate surgery more safe, fast and precise. The article discusses causes of bleeding in functional sinus surgery. MATERIALS AND METHODS It focuses on various techniques and drugs, which can be used by anaesthesiologists to control bleeding. It also discusses the pros and cons of controlled hypotension during this surgery. Various techniques of local instillation of various drugs are discussed. RESULTS Various drugs and techniques are compared and advantages and disadvantages of each are discussed. CONCLUSION Premedication with various drugs, techniques of positioning and controlled hypotension are useful for control of bleeding in functional endoscopic sinus surgery.

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“…During inspiratory phase, the infl ow of blood into the heart signifi cantly decreases, and passive expiration does not reduce this effect (10). In addition, bleeding increases in cases of higher chest pressure, e.g., during coughing or straining (19).…”

Section: Surgical Bleedingmentioning

confidence: 99%