The effects of induced hypotension in a head-up position on amount of blood loss and urine volume in patients undergoing tyroidectomy.

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A comparative study of the effects on blood loss and urine output was carried out in two groups involving 70 patients undergoing hemi-thyroidectomy. In group A (n=50), operation was performed under hypotensive anesthesia in a head-up Position of 20 to 30 degrees.Trimetaphan camsilate was administered to induce hypotension. In group B (n=20), the operating table was placed in a horizontal position and arterial blood pressure was maintained normotensively.In both groups operation was performed under Neuroleptanaesthesia with endotracheal intubation. Mean arterial pressure was measured every 5 minutes. Blood loss and urine output were recorded from the beginning of operation every 30 minutes. In order to elucidate hemodynamic alterations during the change of position, cardiac output, pulmonary artery wedge pressure and pulmonary artery pressure were measured.Amount of blood loss was significantly less in group A than in group B at 30 minutes from the incision (P<0.01) and at 60 minutes (P<0.005). However urine volume was also significantly less in group A than in group B (P<0.01). All cardiac parameters decreased significantly when horizontal position was changed into head-up position.
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