الفهرس 
Patients and methodsOnly 14 pages are availabe for public view
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Abstract
Controlled hypotensive anesthesia represents a great challenge for the anesthetists. It is the elective lowering of arterial blood pressure. The primary advantages of this technique are minimization of surgical blood loss and better wound visualization.
Studies stated a decrease of MAP of 50 to 65 mmHg or a 30% reduction of baseline MAP at the surgical site was believed to decrease blood loss significantly.
There are many techniques to deliberate hypotension as physiological, mechanical and pharmacological methods.
In Pharmacological methods reducing BP act either by lowering the systemic vascular resistance (SVR) or by lowering the cardiac output (CO).
The ideal pharmacological agent for controlled hypotension would have an ease of administration, predictable and dose dependent effect, rapid onset and recovery from effect, quick elimination without production of toxic metabolites, minimal effects on blood flow to vital organs and should not increase the brain size or affect cerebral auto regulation.
Monitoring of hypotensive anesthesia should be done by, blood pressure measurement, electrocardiography, gas exchange, monitoring of central venous pressure, blood gases, acid-base balance, urine output and cerebral blood flow monitoring.
When a clear indication for hypotensive anesthesia exists, several relative contraindications must be considered such as hypertension, myocardial ischemia, cerebrovascular diseases, respiratory.