SynthesisJournal of orthopaedic surgery and research2019
Is deliberate hypotension a safe technique for orthopedic surgery?: a systematic review and meta-analysis of parallel randomized controlled trials.
Synthesis in Journal of orthopaedic surgery and research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Effects of oral clonidine on bleeding in pelvic and acetabular fractures surgery: a randomized controlled trial.BMC musculoskeletal disorders · 2025Trial
- Effect of intravenous low-dose norepinephrine on blood loss in non-tourniquet total knee arthroplasty under general anesthesia: a randomized, double-blind, controlled, single-center trial.Journal of orthopaedic surgery and research · 2023Trial
- Effects of nitroglycerin versus labetalol on peripheral perfusion during deliberate hypotension for sinus endoscopic surgery: a randomized, controlled, double-blinded trial.BMC anesthesiology · 2020Trial
- Perioperative Management of Patients Undergoing Periacetabular Osteotomy: An Evidence-Based Review.Current reviews in musculoskeletal medicine · 2026Review
- Remifentanil Diminishes Stimulation-Induced Oral Tissue Blood Flow Changes.Anesthesia progress · 2026Article
- Effects of Remimazolam With or Without Remifentanil on Oral Tissue Blood Flow and Oxygen Tension in Rabbits.Anesthesia progress · 2025Article
- Effect of tranexamic acid on blood loss reduction in patients undergoing orthognathic surgery under hypotensive anesthesia: a single-center, retrospective, observational study.Journal of the Korean Association of Oral and Maxillofacial Surgeons · 2024Article
- Quantile regression-based prediction of intraoperative blood loss in patients with spinal metastases: model development and validation.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2023Article
- Hypotensive Anesthesia Combined with Tranexamic Acid Reduces Perioperative Blood Loss in Simultaneous Bilateral Total Hip Arthroplasty: A Retrospective Cohort Study.Orthopaedic surgery · 2022Article
- Resuscitative Endovascular Balloon Occlusion of the Aorta for Blood Control in Lumbar Spine Tumor Resection Surgery: A Technical Note.Orthopaedic surgery · 2021Article
- Article
- Non-invasive continuous blood pressure monitoring (ClearSight™ system) during shoulder surgery in the beach chair position: a prospective self-controlled study.BMC anesthesiology · 2020Article
- Blood usage among orthopedic patients at the Rivers State University Teaching Hospital, Port Harcourt, Nigeria.Nigerian medical journal : journal of the Nigeria Medical AssociationArticle
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDeliberate hypotension has been shown to reduce the intraoperative bleeding and the need for allogeneic blood transfusion, and improve the surgical field, but there is still controversy on its clinical safety. This systematic review was designed to assess the safety and benefits of deliberate hypotension for orthopedic surgery.
methodsThe review met the requirements of the PRISMA guidelines. The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, ISI Web of Science, ScienceDirect, and four Chinese databases (China National Knowledge Infrastructure, Wanfang, vip citation database, and updated version of China Biology Medicine disc from January 1, 2000 to January 1, 2019) were searched. All parallel randomized controlled trials comparing the effects of using deliberate hypotension with not using deliberate hypotension on clinical outcomes of patients undergoing orthopedic surgery were selected. The primary outcome was overall mortality. The secondary outcomes were the intraoperative blood loss, blood transfusion volume, and serious adverse postoperative events.
resultsA total of 30 studies with 36 comparisons (1454 participants) were included in meta-analysis. Two studies with 120 participants reported overall mortality and the result was zero (low-quality evidence). The use of deliberate hypotension reduced the intraoperative blood loss (mean difference, - 376.7; 95% CI - 428.1 to - 325.3; I
conclusionsBased on the available evidence, it is still unclear whether or not deliberate hypotension is a safe technique for orthopedic surgery due to limited studies with very small sample size, though it may decrease the intraoperative blood loss and blood transfusion volume irrespective of age groups, controlled mean artery pressure levels, types of surgeries, hypotensive methods, or different combinations of other blood conservation strategies.
trial registrationPROSPERO CRD42016045480.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.