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Reducing Blood Pressure for Safer Surgery

When performing arthroscopic shoulder surgery, the surgeon often asks the anesthesiologist to keep the blood pressure low in order to reduce bleeding. This allows the doctor to the shoulder more clearly and operate safely.

But, some doctors are concerned that if you lower the blood pressure, you may injure the brain, causing a stroke.

A group from the anesthesia department undertook a project to determine if there is a connection between blood pressure and stroke during shoulder surgery.

We examined over 4,000 shoulder surgeries. The anesthesia for almost every case was a nerve block with sedation. About half of the cases had low blood pressure by common standards. Even so, not a single patient had any evidence of brain injury or dysfunction, including those we called one week after surgery.

In conclusion, controlled hypotension seems to be relatively safe for these patients and can be recommended.

Full reference:
Yadeau JT, Casciano M, Liu SS, Edmonds CR, Gordon M, Stanton J, John R, Shaw PM, Wilfred SE, Stanton M. Stroke, regional anesthesia in the sitting position, and hypotension: a review of 4169 ambulatory surgery patients. Reg Anesth Pain Med. 2011 Sep-Oct;36(5):430-5.u