| Hypotensive epidural anesthesia for total hip arthroplasty: a review. | |
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MedLine Citation:
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PMID: 8615115 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Hypotensive epidural anesthesia provides arterial hypotension to maintain a mean arterial pressure of 50 mmHg and it can be used to reduce blood loss during total hip replacement. The technique combines an extensive epidural blockade with an intravenous infusion of low-dose epinephrine. This results in arterial hypotension, but with preservation of central venous pressure, heart rate, stroke volume, cardiac output, and an augmentation of blood flow to the lower extremity. The technique does not appear to adversely affect cardiac, renal, or cerebral function and is used safely in patients with hypertension, ischemic heart disease, and in the elderly. Intraoperative blood losses during primary total hip replacement are between 100 and 300 mL. Perioperative transfusions have declined with the introduction of the technique. Radiological evidence of improved fixation of cemented acetabular components has been observed. Rates of deep-vein thrombosis are low: 2-3% proximal deep-vein thrombosis with an overall rate of 10%. In-hospital mortality is 0.1%; lower than previously published rates. In conclusion, hypotensive epidural anesthesia is safe and provides a number of advantages over conventional anesthetic techniques for total hip replacement. |
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Authors:
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N E Sharrock; E A Salvati |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Review |
Journal Detail:
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Title: Acta orthopaedica Scandinavica Volume: 67 ISSN: 0001-6470 ISO Abbreviation: Acta Orthop Scand Publication Date: 1996 Feb |
Date Detail:
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Created Date: 1996-06-06 Completed Date: 1996-06-06 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0370352 Medline TA: Acta Orthop Scand Country: NORWAY |
Other Details:
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Languages: eng Pagination: 91-107 Citation Subset: IM |
Affiliation:
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Department of Anesthesiology, The Hospital for Special Surgery, New York, NY 10021, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Anesthesia, Epidural*
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contraindications,
methods Hip Prosthesis / methods* Humans Intraoperative Complications Postoperative Complications / prevention & control Risk Factors Thromboembolism / etiology |
| Comments/Corrections | |
Comment In:
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Acta Orthop Scand. 1996 Feb;67(1):1
[PMID:
8615091
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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