| Title |
Hipotenzinė anestezija atliekant klubo ir kelio sąnarių endoprotezavimą: į tikslą nukreiptas skysčių terapijos algoritmas / |
| Translation of Title |
Hypotensive anaesthesia in total hip and knee arthroplasty: algorithm for the goal-directed fluid management. |
| Authors |
Andrijauskas, Audrius ; Ivaškevičius, Juozas ; Kocius, Manvilius ; Porvaneckas, Narūnas ; Činčikas, Darius ; Oševska, Jevgenija |
| DOI |
10.15388/LietChirur.2008.4.2145 |
| Full Text |
|
| Is Part of |
Lietuvos chirurgija.. Vilnius : Vilniaus universiteto leidykla. 2008, t. 6, Nr. 4, p. 281-295.. ISSN 1392-0995. eISSN 1648-9942 |
| Keywords [eng] |
hemodynamics ; goal-directed-management ; fluid ; transfusion ; algorithm |
| Abstract [eng] |
Hypotensive anaesthesia is a technique that deploys the controlled reduction of mean arterial pressure. It has been used for decades to reduce intraoperative blood loss and related blood transfusions, also to ensure the ‘dry operating field’ and minimize the tourniquet inflation pressure in patients undergoing total hip (THA) and knee (TKA) arthroplasty. Hypotensive anesthesia can be achieved in different ways such as (a) by decreasing cardiac output with vasodilatory agents, (b) inducing the sympathetic block by spinal and/or epidural anaesthesia, and/or (c) by using potent anesthetic gases in general anaesthesia. The major concern in the method’s clinical applicability is the patient’s safety. Inherent risks related to hypotensive anaesthesia are mainly associated with the concern of occult tissue hypoperfusion resulting from inadequately compensated relative hypovolemia. Therefore, maintaining an effective circulating volume (normovolemia) is crucial for the safe management of controlled arterial hypotension. However, the lack of a simple, reliable and effective method for the guidance of appropriate measures is an ongoing deficiency. Conventional strategies aiming to establish, monitor and maintain normovolemia are currently replaced by the goal-directed management (GDM) in fluid therapy. It has already become a standard of care in selected patients such as those undergoing major abdominal surgery. On the basis of goal-directed fluid management, authors have developed a GDM algorithm for the optimization of fluid status, aiming to secure normovolemia during hypotensive anaesthesia. The new algorithm is highlighted along with a review of related issues of its clinical application. |
| Published |
Vilnius : Vilniaus universiteto leidykla |
| Type |
Journal article |
| Language |
Lithuanian |
| Publication date |
2008 |
| CC license |
|
