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Hypotensive anaesthesia for spine surgery--nitroglycerin vs halothane

P P Kadam1, S G Saksena, S R Jagtap

  • 1Dept. of Anaesthesiology, LTMMC and LTMG Hospital, Sion, Bombay, Maharashtra.

Journal of Postgraduate Medicine
|January 1, 1993
PubMed
Summary

Nitroglycerin infusion significantly reduced blood loss and improved patient recovery scores during spine surgery compared to halothane. This method offers a safe and effective approach for hypotensive anesthesia in spinal procedures.

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Area of Science:

  • Anesthesiology
  • Neurosurgery
  • Surgical Safety

Background:

  • Controlled hypotension is crucial in spine surgery to minimize blood loss and improve surgical field visualization.
  • Traditional anesthetic agents like halothane can be associated with significant blood loss and slower patient recovery.

Purpose of the Study:

  • To compare the efficacy and safety of continuous intravenous nitroglycerin infusion versus halothane for inducing controlled hypotension during spine surgery.
  • To evaluate the impact of these anesthetic techniques on intraoperative blood loss, operating time, and postoperative recovery.

Main Methods:

  • A randomized study involving 30 patients (ASA I or II) undergoing spine surgery under general anesthesia.
  • Two groups were formed: one receiving halothane (0.5-2.5%) and the other receiving continuous intravenous nitroglycerin infusion (1-2 µg/kg/min) to maintain systolic blood pressure between 80-100 mmHg.

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  • Key parameters monitored included blood pressure, blood loss, operating time, and recovery scores.

    • Main Results:

    • Nitroglycerin group exhibited significantly less blood loss (202 ± 114 ml) compared to the halothane group (602 ± 312 ml).
    • Patients in the nitroglycerin group showed faster and better recovery (recovery score 9.8 ± 0.76) versus the halothane group (7.98 ± 0.9, p < 0.01).
    • No tachycardia or tachyphylaxis was observed with nitroglycerin infusion.

    Conclusions:

    • Continuous intravenous nitroglycerin infusion is an effective and safe method for achieving controlled hypotension in spine surgery.
    • Nitroglycerin significantly reduces blood loss and operating time, leading to improved patient outcomes and faster recovery compared to halothane.