Canadian Journal of Anesthesia, Vol 10, 244-258, Copyright © 1963 by Canadian Anesthesiologists' Society

Physiological Changes with Induced Hypotension, Present Status of Clinical Use

¹ Department of Anaesthesia, Queen's University, Kingston, Ontario

It would appear from recently reported series that the technique of induced hypotension is now being used more freely in some types of surgery, in which it was not formerly used, or for which it was not originally conceived. It is also noted that induced hypotension has fallen into disfavour for certain types of intracranial surgery. As experience with induced hypotension has accumulated, the indications for its use appear to have changed. As stated by Little in 1962,⁵⁵ "very few of these operative procedures on very few of the patients would satisfy the rigid criteria that the indications for the use of the hypotensive techniques must consist in the probable failure either of the patient to survive the operation, or of the surgery to be completed successfully, without the use of induced hypotension." It would appear that the technique is currently being used to achieve minimal bleeding; easier, more rapid, and safer surgery; minimal need for blood replacement; and an increased tolerance for the stress of surgery and anaesthesia. It is debatable whether these gains justify the risks involved in many of the patients who come to surgery.