November 1, 1994Anesthesia & Analgesia

Deliberate Hypotensive Epidural Anesthesia for Patients with Normal and Low Cardiac Output

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Why the study?

Does deliberate hypotensive epidural anesthesia improve systemic hemodynamics in patients with chronic left ventricular dysfunction undergoing total hip arthroplasty?

Population

29 patients with chronic left ventricular dysfunction undergoing total hip arthroplasty.

Design

Cohort

Follow-up

Perioperative (up to 30 minutes after epidural injection)

Authors

NSNigel E. SharrockHospital for Special Surgery BBBirgit BadingUniversity Clinic of Traumatology RMRobert MineoHospital for Special Surgery

Discussion

Member takes

Implication

Epidural anesthesia was associated with higher cardiac index in LV dysfunction; hypothesis-generating and should not yet change practice.

Structured PICO

Does deliberate hypotensive epidural anesthesia improve systemic hemodynamics in patients with chronic left ventricular dysfunction undergoing total hip arthroplasty?

Population

29 patients with chronic left ventricular dysfunction (including history of congestive heart failure or low preanesthetic cardiac index ≤ 2.5 L.kg-1.m-2) undergoing total hip arthroplasty.

Intervention

Deliberate hypotensive epidural anesthesia using low-dose intravenous epinephrine infusion to maintain mean arterial pressure (MAP) at 50-60 mm Hg.

Outcome

Systemic hemodynamic responses (mean arterial pressure, cardiac index, stroke volume index) at 30 minutes after epidural injection.surrogate

Deliberate hypotensive epidural anesthesia safely improves cardiac index and stroke volume in patients with left ventricular dysfunction undergoing total hip arthroplasty, challenging its traditional contraindication.

Cite This Study

Sharrock et al. (1994) studied this question.

synapsesocial.com/papers/6a8932a41fe1bad943eb14bf https://doi.org/10.1213/00000539-199411000-00014

View Full Paper

Ask AI

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Deliberate Hypotensive Epidural Anesthesia for Patients with Normal and Low Cardiac Output

Discussion

Member takes

Implication

Structured PICO

Cite This Study

Deliberate Hypotensive Epidural Anesthesia for Patients with Normal and Low Cardiac Output

Discussion

Member takes

Implication

Structured PICO

Cite This Study

Also Consider

Also Consider