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Hypotensive Anesthesia in Total Hip Replacement

Thomas H. Mallory, MD
JAMA. 1973;224(2):248. doi:10.1001/jama.1973.03220150056025.
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To the Editor.—  Controlled hypotensive anesthesia using pentolinium tartrate has been beneficial in total hip replacement. Hypotensive anesthesia in hip replacement was first advocated by John Charnley in England. Jennings et al recently advocated its use at the American Academy of Orthopaedic Surgeons Meeting in 1973. My personal experience with hypotensive anesthesia has been similarly favorable.Forty patients undergoing total hip replacement were operated on under general anesthesia using pentolinium to lower the blood pressure to the diastolic level. A similar group of patients were operated on under normal tensive anesthesia as a basis of comparison. Patients with a history of coronary insufficiency, advanced arteriosclerosis, or previous renal disease were not included in this study.The patients' blood volumes were evaluated preoperatively in order to assure an adequate volemic state prior to the use of pentolinium. The agent was started prior to the skin incision and maintained throughout the operative


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