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Canadian Journal of Anesthesia, Vol 29, 452-462, Copyright © 1982 by Canadian Anesthesiologists' Society

Deliberate Hypotension for Spinal Fusion: Prospective Randomized Study with Evoked Potential Monitoring

BETTY L. GRUNDY M.D.1, CLYDE L. NASH JR. M.D.2, and RICHARD H. BROWN Ph.D.2

1 University of Pittsburgh
2 Case Western Reserve University

Twenty-four patients requiring spinal fusion with Harrington rod instrumentation were studied prospectively to determine the effects of moderate hypotension on blood loss, operating conditions, operating time and spinal cord function. Hypotension reduced blood loss and improved operating conditions but did not shorten operating time. Five patients had alterations in somatosensory cortical evoked potentials after straightening of the spine that prompted us to reverse hypotension (when present) and haemodilution, and then to do wake-up tests. All wake-up tests were normal and all evoked potential alterations resolved during operation. Hypotension seems unlikely to increase the risk of neurological damage if spinal cord function is monitored. Our findings suggest that patients subjected to spinal fusion need not be awakened during operation for testing of cord function provided somatosensory evoked potentials are monitored and remain stable.

Key Words: SURGERY, spinal fusion • ANAESTHETIC TECHNIQUES, induced hypotension • MONITORING, cortical evoked potentials






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Copyright © 1982 by the Canadian Anesthesiologists' Society.