THE EFFECT OF 2 LEVELS OF HYPOTENSION ON INTRAOPERATIVE BLOOD-LOSS DURING TOTAL HIP-ARTHROPLASTY PERFORMED UNDER LUMBAR EPIDURAL-ANESTHESIA

The degree of induced hypotension necessary to achieve a significant r eduction in intraoperative blood loss has never been defined. Forty pa tients undergoing primary total hip arthroplasty during epidural anest hesia by a single surgeon were randomly assigned to have mean arterial pressure maintained at 50 +/- 5 mm Hg or 60 +/- 5 mm Hg throughout su rgery, Intraoperative blood loss was 179 +/- 73 mL in the 50 mm Hg gro up and 263 +/- 98 mL in the 60 mm Hg group (P = 0.004). Subjectively, there was more bleeding during surgery in the 60 mm Hg group during di ssection of the hip joint (P = 0.0026) and while reaming the acetabulu m (P = 0.0001) and femur (P = 0.0001). No difference in transfusion re quirements, postoperative hematocrit, or duration of surgery was noted . A difference in mean arterial blood pressure of 10 mm Hg from 50 to 60 mm Hg during surgery for total hip arthroplasty under epidural anes thesia has a measurable effect on intraoperative blood loss.