The use of hypotensive technique in conjunction with brachial plexus blockanesthesia for surgery of the upper extremity

SURGERY to internally fix pathologic fractures of the humerus may result in substantial blood loss for several reasons. For one, it is difficult to ap ply an effective tourniquet because of the proximal location of many of the se lesions. Furthermore, pathologic humeral lesions may be highly vascular, leading to bleeding when excised.(1,2) We report the use of hypotensive an esthesia, in conjunction with interscalene block anesthesia, to manage surg ery in a patient with such a lesion.