[Controlled hypotension in transthoracic esophageal resection].
OBJECTIVE
This study was performed in order to evaluate effectiveness of controlled hypotension decreasing blood lose in transthoracic esophageal resection.


METHODS
Thirty-six patients were enrolled in this randomized study. The patients were divided in to two groups. We used controlled hypotension induced by thoracic epidural anaesthesia for the group T (n=18/50%). For the group K (n=18/50%) we used only endotracheal anesthesia. The median arterial pressure was about 50 mmHg in group T and 80-110 mmHg in group K. We investigated intra-operative and post-operative blood loss, the average operating time, opioid and inhaled anesthetic use and stay in intensive care unite.


RESULTS
The intra-operative blood loss was less for 45.7% in group T than in group K but post-operative blood loss was the same in groups. The mean operation time was 14.2% shorter in group T. We used 80% less fentanyl and 43% less inhaled anesthetics in group T. The stay in intensive care unit was 2.6 days in group T and 3.9 in group K. There were no significant complications caused by controlled hypotension.


CONCLUSIONS
We conclude that controlled hypotension is an effective method to decrease blood loos and blood transfusions. It creates better conditions for surgery and reduces operation time. There were no serious cardiac, neurological and renal intra-operative and post-operative complications resulting from the use of controlled hypotension.
Tikuisis
Renatas
R
Institute of Oncology, Vilnius University, Santariskiu 1, 2021 Vilnius, Lithuania. renatas@loc.lt
Cicenas
Saulius
S
Miliauskas
Povilas
P
Zurauskas
Aleksas
A
D000280:Administration, Inhalation; D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000770:Anesthesia, Endotracheal; D000767:Anesthesia, Epidural; D000777:Anesthetics / Q000008:administration & dosage; D016063:Blood Loss, Surgical; D001794:Blood Pressure; D001803:Blood Transfusion; D004938:Esophageal Neoplasms / Q000601:surgery*; D004947:Esophagus / Q000601:surgery*; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D006801:Humans; D007023:Hypotension, Controlled / Q000009:adverse effects; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D018579:Patient Selection; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D013997:Time Factors
D000701:Analgesics, Opioid; D000777:Anesthetics; D005283:Fentanyl