अमूर्त

Intraoperative Controlled Hypotension- A review of the literature and 60 years of personal experience from the point of view of Anesthesiologists.

Hanna Perez-Chrzanowska*, Patricia Serrano Mendez and Ricardo Pintado Otero

Intraoperative controlled hypotension was introduced a century ago with the aim of reducing blood loss and thus decreases the transfusion rates. It consists of intentionally lowering the blood pressure of the patient to a predetermined level, always under the strict supervision of an experienced anesthesiologist. It offers the surgeon improved operating field visibility conditions, increasing surgical precision and thus decreasing complications and operating time. It is a versatile technique used in diverse surgical specialties although it is not without controversies. At present, the discovery of drugs with predictable and easily titratable effects, simple administration and improved safety profiles, as well as sophisticated non-invasive monitorization, allow this technique to be performed with total security.

In this article we will review the pharmacology of drugs that have been used to produce controlled hypotension over the last 100 years, its indications and complications. We will describe the pathophysiological basis, the monitoring required to perform it safely and we will make recommendations based on the personal experience of the authors whose practice of this technique spans 60 years.