Hypotensive epidural anesthesia in total knee replacement without tourniquet: reduced blood loss and transfusion

摘要: Background and Objectives: For decades, hypotensive anesthesia has been used in an attempt to reduce intraoperative blood loss. Hypotensive epidural (HEA) is a relatively new technique anesthesia. Use of tourniquet shown be associated with higher risk cardiovascular thromboembolic complications. The effect HEA on loss need for transfusion total knee replacement (TKR) not known. Methods: Thirty consecutive patients scheduled TKR were randomized without or spinal the use (SPI). was performed as epidurally induced sympathetic block there infusion low-dose epinephrine stabilize circulation. Results: Intraoperative mean arterial pressure 48 mm Hg versus 83 (SPI) (P < .001). 146 mL 13 Postoperative at any time significantly reduced group, 1,056 1,826 Half bleeding took place during first 3 postoperative hours 80% 24 hours. In 57% went through surgery hospital stay receiving 19% SPI group .05). There amount (193 mL) 775 .005). No cardiopulmonary, cerebral, renal complications registered. Conclusions: We conclude that safe allows tourniquet. Compared anesthesia, reduces transfusion. Reg Anesth Pain Med 2001;26:105-110.