The effect of hypotensive anesthesia on cephalosporin concentrations in serum, soft tissue, and bone

The objective of this study was to determine the efficacy of a hypotensive anesthetic in enhancing tissue perfusion while simultaneously controlling surgical blood loss. One hundred ten patients undergoing 126 total hip arthroplasties were administered either cephalothin or cefamandole on a double-blind basis. Hypotensive anesthesia was administered to 64 patients; 46 received a normotensive anesthetic. Degree of tissue perfusion was measured by the concentration of cephalosporin found in samplings of serum, soft tissue, and bone. These samples, obtained during the course of total joint arthroplasty, indicate that the hypotensive anesthetic sodium nitroprusside did not significantly alter the concentrations of cefamandole or cephalothin from those found in the normotensive group.