The Effect of Anaesthesia, Hypotension, and Epidural Analgesia on Blood Loss in Surgery for Pelvic Floor Repair

Donald, Jill

doi:10.1093/bja/41.2.155

Cited by 15 publications

(11 citation statements)

References 25 publications

(31 reference statements)

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“…Intraoperative blood loss has been attributed to multiple clinical variables, including age [12], physical status [7], type of surgery [13], surgeon [14], and anatomic and physiologic differences between patients [8]. We have not noticed any difference in age, physical status, type of surgery, surgeon and anatomic and physiologic specifications between our study groups.…”

Section: Discussionmentioning

confidence: 50%

“…Ozyuvaci/Altan/Karadeniz/Topsakal/ Besisik/Yucel pared blood loss with different anesthetics, one or more of these variables were not controlled within the different anesthetic groups [7,8,14]. In medical literature concerning intraoperative blood loss, a significantly lower blood loss (and thus transfusion requirement) was noticed in patients given spinal anesthesia, continuous epidural anesthesia or interscalene block when compared with a general anesthetic group following hip or knee replacement and shoulder surgery [15,16].…”

Section: Group Cegamentioning

confidence: 99%

“…These include inadvertent mismatched transfusions, transfusion reactions and toxicity, and disease transmission [7,8]. Thus, efforts to minimize intraoperative bleeding and blood transfusion are justified.…”

Section: Introductionmentioning

confidence: 99%

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General Anesthesia versus Epidural and General Anesthesia in Radical Cystectomy

Ozyuvaci¹,

Altan²,

Karadeniz

et al. 2005

Urol Int

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Introduction: The aim of this study is to compare two different anesthetic techniques in radical cystectomy with regard to blood loss, transfusional requirements, intraoperative complications and the quality of analgesia. Materials and Methods: 50 patients scheduled for radical cystectomy were randomized to two groups: group GA – general anesthesia, n = 25 and group CEGA – combined epidural and general anesthesia. The patients were monitored and hemodynamic changes, intraoperative bleeding, transfusional requirements, quality of analgesia and postoperative complications were evaluated. Results: There were no significant differences between the demographic characteristics of the two groups. Intraoperative bleeding which was 874.8 ± 190.7 ml in the CEGA group and 1,248.3 ± 343.4 ml in the GA group was statistically different (p < 0.05). Significantly more intraoperative blood transfusions in terms of units were required in the GA group. Analgesia was better in the CEGA group, with VAS values at 0, 1, 2, 4, 6, 12 and 24 h significantly (p < 0.05) lower than those observed in the GA group. No significant differences in intraoperative hemodynamic parameters or postoperative complications were noted between the two groups. Conclusions: Statistically significant differences in intraoperative bleeding were observed between the two groups: CEGA provides lower intraoperative bleeding and a better postoperative analgesia. Major operations such as radical cystectomy, which also is associated with considerable blood loss, a combination of general and epidural anesthesia may allow for less blood loss, with a better postoperative analgesia and without any increase in complications.

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Section: Discussionmentioning

confidence: 50%

Section: Group Cegamentioning

confidence: 99%

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General Anesthesia versus Epidural and General Anesthesia in Radical Cystectomy

Ozyuvaci¹,

Altan²,

Karadeniz

et al. 2005

Urol Int

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“…Orthodox hypotension reduces bleeding by only 50%, which is small when the influence of the other unknown factors are considered. In my own series (Donald, 1969) the range of blood loss at pelvic floor repair was 32-1200 ml, which is fairly representative of all studies. Dr Kerr's study also suggests that arterial pressure is not a major factor in reducing bleeding, as there was a failure rate of up to 39.3% depending on the patient's age, despite very low arterial pressures.…”

Section: Profound Hypotension For Middle Ear Surgerymentioning

confidence: 58%

“…This assumption has never been examined adequately, but a clinical impression exists, for which there is some evidence (Donald, 1969), that the lowest arterial pressure necessary to produce maximal effects on blood loss is about 90-110 mm Hg. Any decrease in arterial pressure to less than this value increases anaesthetic morbidity and mortality without improving operating conditions.…”

Section: Profound Hypotension For Middle Ear Surgerymentioning

confidence: 99%