It is recommended that Hypotensive anesthesia be adjusted in relation to the patient's preoperative blood pressure rather than a specific target pressure and be limited to that level necessary to reduce bleeding in the surgical field and in duration to that part of the surgical procedure deemed to benefit by it.
Elevation of the head during hypotensive anesthesia can aggravate the decrease in cerebral perfusion pressure.
Thus, it is essential to maintain the oxygen saturation within normal limits, which may necessitate giving more than the normal amount of oxygen during hypotensive anesthesia. However, 100% oxygen is not preferable during hypotension, as this may cause vasoconstriction, especially in the brain.
Hypotensive anesthesia may substantially decrease coronary blood flow.
(18) All these factors result in oliguria during hypotensive anesthesia. However following termination of hypotensive anesthesia, urine formation rapidly recovers, provided the patient is well hydrated.
Since the aim of hypotensive anesthesia is to reduce blood loss and provide easily visualizes surgical field, the degree of reduction should depend on each individual patient and clinical situation.
Skin Necrosis: Necrosis of the skin with ulcer formation can occur after prolonged hypotensive anesthesia from pressure-induced hypoperfusion.