Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Hypotension, Controlled”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMed2000

[Neurophysiological monitoring during scoliosis surgery using controlled hypotension].

Controlled arterial hypotension understood to be a mean arterial pressure (MAP) between 55 and 60 mmHg is often used as a complementary technique in anesthesia even though it is not without complications and associated mortality even in young patients. During surgery to reduce scoliosis in a young boy, MAP fell to 60 mmHg accompanied by bilateral loss of sensory and motor evoked potentials (SEP and MEP). Detecting the absence of SEP and MEP allowed us to prevent medullar injury due to ischemia secondary to hypotension, once possible surgical or technical causes had been ruled out. We believe that monitoring SEP and MEP is useful not only to the surgeon but also to the anesthesiologist.

Adolescent↗
PubMed2005

Cerebral oxygenation monitoring using near infrared spectroscopy during controlled hypotension.

BACKGROUND: Controlled hypotension (CH) is used to limit intraoperative blood loss and decrease the need for homologous transfusions. Despite the efficacy of the technique, hypotension has the potential to affect cerebral perfusion and oxygen delivery. There are no data providing a direct measurement of cerebral oxygenation during this technique. METHODS: The current study prospectively evaluated cerebral oxygenation during CH using near infrared spectroscopy. Nineteen patients ranging in age from 6 to 18 years were enrolled in the study. CH was provided using a combination of intravenous opioids and sevoflurane supplemented with labetolol as necessary. RESULTS: There were a total of 268 readings obtained from the cerebral oximeter. The baseline cerebral oximeter reading was 81+/-8% on the right and 82+/-7% on the left. During CH (mean arterial pressure of 65-69, 60-64, 55-59, and <54 mmHg), the right cerebral oximeter values were 80+/-9, 78+/-8, 78+/-10, and 84+/-9%, respectively while the left cerebral oximeter values were 79+/-7, 80+/-7, 78+/-8, and 78+/-8%, respectively. Of the 268 readings, there were 11 points (4%) at which either the left or right cerebral oximeter was 10-19 less than the baseline value and no points at which the reading was 20 or more from the baseline value. CONCLUSIONS: Our preliminary data with a measurement of cerebral oxygenation demonstrates the safety of CH within the accepted mean blood pressure recommendations of 55-65 mmHg.

Adolescent↗
PubMed1994

[Angiotensin converting enzyme inhibitors in controlled hypotension during spinal surgery].

BACKGROUND: Controlled hypotension is an advantage during spondylosurgical operations: the objective is to achieve a mean arteriae pressure of 8 kPa (60 mm Hg). The most frequently used 0.01% solution of sodium nitroprusside must be increased in some patients to amounts which involve the risk of intoxication. This applies to patients with an increased sympathoadrenal activity and ready mobilization of the renin-angiotensin system. The objective of the present investigation was to test the inhibitor of the angiotensin converting enzyme in hypotension controlled by nitroprusside. METHODS AND RESULTS: To twenty patients before a spondylosurgical operation as premedication angiotensin converting enzyme inhibitor (ACE)--captopril--was administered, 25 mg by the oral route. The control group was formed by 20 patients with spondylosurgery under controlled hypotension with nitroprusside administration. The effect of captopril was manifested by a reduced amount of nitroprusside needed to maintain the median pressure of 8 kPa; in the captopril group 1.073 +/- 0.52 microgram.kg-1.min-1 was used, as compared with 1.786 +/- 1.04 micrograms.min-1 in the control group (p < 0.01). Concurrently monitored values of plasma renin activity were higher in the patients given captopril: 7.352 +/- 5.75 nmol.l-1, as compared with 5.583 +/- 3.73 nmol.l-1 (p < 0.05). CONCLUSIONS: Premedication with ACE inhibitor (captopril), even when administered in small doses via p. o., reduced the sodium nitroprusside consumption by as much as 60%. The elevated plasma renin values were objective evidence of the effect of captopril.

Adolescent↗
PubMed1998

Autoregulation of human inner ear blood flow during middle ear surgery with propofol or isoflurane anesthesia during controlled hypotension.

UNLABELLED: We used controlled hypotension to obtain a bloodless cavity during middle ear surgery under an optical microscope. No previous study has assessed the effect of controlled hypotension on inner ear blood flow (IEF) autoregulation in humans receiving propofol or isoflurane anesthesia. In the present study, the IEF autoregulation was determined using laser Doppler flowmetry in combination with transient evoked otoacoustic emissions (TEOAEs) during controlled hypotension with sodium nitroprusside in 20 patients randomly anesthetized with propofol or isoflurane. A coefficient of IEF autoregulation (Ga) was determined during controlled hypotension, with a Ga value ranging between 0 (no autoregulation) and 1 (perfect autoregulation). During controlled hypotension with propofol, IEF remained stable (1%+/-6%; P > 0.05) but decreased by 25%+/-8% with isoflurane (P < 0.05). The Ga was higher during propofol anesthesia (0.62+/-0.03) than during isoflurane anesthesia (0.22+/-0.03; P < 0.0001). Under propofol anesthesia, there were individual relationships between TEOAE amplitude and change in IEF in four patients. Such a correlation was not observed under isoflurane anesthesia. These results suggest that human IEF is autoregulated in response to decreased systemic pressure. Furthermore, isoflurane has a greater propensity to decrease cochlear autoregulation and function than propofol. IMPLICATIONS: The present study shows that inner ear blood flow is autoregulated under propofol, but not isoflurane, anesthesia during controlled hypotension in humans during middle ear surgery. Further studies are needed to explore the postoperative auditory functional consequences of the choice of the anesthetic drug used in middle ear surgery.

Adult↗
PubMed1988

Safety limits of controlled hypotension in humans.

Controlled hypotension is a safe and convenient means of allowing a surgeon to perform intracranial aneurysm, arteriovenous malformation and vascular tumor surgery. The mean arterial pressure between 40 and 60 mmHg induces diminished pulsatile arterial pressure, thus preventing rupture of these abnormal vasculatures. It is still possible to maintain cerebral metabolism in the functional level within this 40-60 mmHg blood pressure range. This statement is based on our experience of the physical and neurological outcome of patients after surgery, and on analyses of somatosensory evoked potential and redox of cytochrome a, a3 in the mitochondria of the cerebral cortical cells.

Adolescent↗