title: The effect of milrinone on induced hypotension in elderly patients during spinal surgery: a randomized controlled trial.
abstract: BACKGROUND
  Induced hypotension is widely used intraoperatively to reduce blood loss and to improve the surgical field during spinal surgery.
  
  
  OBJECTIVE
  To determine the effect of milrinone on induced hypotension during spinal surgery in elderly patients.
  
  
  METHODS
  Prospective randomized clinical trial.
  
  
  METHODS
  Forty patients, 60 to 70 years old, ASA I-II, who underwent elective lumbar fusion surgery.
  
  
  METHODS
  Intraoperative hemodynamics, blood loss, hourly urine output, and grade of surgical field.
  
  
  METHODS
  All patients were randomized to group M or N. The study drug was infused after perivertebral muscle retraction until complete interbody fusion. In group M, 50 μg/kg/min of milrinone was infused over 10 minutes as a loading dose followed by 0.6 μg/kg/min of milrinone as a continuous dose. In group N, an identical volume of normal saline was infused in the same fashion. This study was not funded by commercial or other sponsorship and the authors confirm no conflicts of interest, financial or otherwise.
  
  
  RESULTS
  During infusion of the study drug, the systolic and mean blood pressures were maintained within adequate limits of induced hypotension in group M. Intraoperative blood loss was 445.0±226.5 mL in group M and 765.0±339.2 mL in group N (p=.001). Hourly urine output was 1.4±0.6 mL in group M and 0.8±0.2 mL in group N (p<.001). The grade of the surgical field was better in group M than in group N (p=.004).
  
  
  CONCLUSIONS
  We conclude that milrinone is useful for induced hypotension in elderly patients during spinal surgery.
authors: Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, 202 Banpo-Daero, Seocho-gu, Seoul 137-701, Korea.
authors: Wonjung
authors: W
authors: Hwang
authors: Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, 202 Banpo-Daero, Seocho-gu, Seoul 137-701, Korea. Electronic address: euns1503@catholic.ac.kr.
authors: Eunsung
authors: E
authors: Kim
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D004311:Double-Blind Method; D017558:Elective Surgical Procedures; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007022:Hypotension / Q000139:chemically induced*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020105:Milrinone / Q000627:therapeutic use*; D011446:Prospective Studies; D013123:Spinal Fusion / Q000379:methods*; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use*
chemical_list: D014665:Vasodilator Agents; D020105:Milrinone
keywords: Induced hypotension; Lumbar spinal surgery; Milrinone