Anesthetic Techniques and Surgical Blood Loss in Total Hip Arthroplasty

Abstract

Blood loss during total hip arthroplasty and the relation of different anesthetic techniques to surgical bleeding was explored in a consecutive prospective study involving 157 patients with no previous history of hip surgery. Intraoperative blood loss was significantly reduced in patients operated under sodium nitroprusside-induced hypotensive anesthesia as compared to halothane, NLA [neuroleptanesthesia] or epidural block. Regression analysis between mean arterial pressure and intraoperative blood loss in patients anesthetized with hypotensive as well as normotensive techniques showed a poor correlation. Blood loss was greater with NLA and halothane anesthesia than with epidural block. Evidently, controlled hypotension is a useful adjuvant in anesthesia for total hip arthroplasty in selected patients. Epidural block is a suitable anesthetic technique for most patients and has the additional advantage of reduced surgical bleeding as compared to general anesthesia.