Hypotensive Anesthesia does not reduce Transfusion Rates during and after Acetabular Fracture Surgery.

ABSTRACT Background: Acetabular fracture open reduction and internal fixation (ORIF) is generally associated with high intraoperative blood loss. Hypotensive anesthesia has been shown to decrease blood loss and intraoperative transfusion in total joint arthroplasty and posterior spinal fusion. In this study, we assessed the effect of reduction in intraoperative mean arterial pressures (MAPs) during acetabular fracture surgery on intraoperative blood loss and need for transfusion. Methods: Three hundred and one patients with acetabular fractures who underwent ORIF at an academic Level 1 trauma center were retrospectively reviewed. Patients were separated based on mean intraoperative MAPs ( 70 mmHg). Thirteen patients had mean intraoperative MAP 70 mmHg. Rates of intraoperative and postoperative allogeneic blood transfusion. Results: Mean intraoperative MAPs were significantly different between groups (p 30 (p Conclusion: Decreased intraoperative MAP during acetabular fracture surgery does not reduce blood loss or need for transfusion. On the other hand, no increased end-organ ischemia was seen with hypotensive anesthesia. Level of Evidence: Therapeutic Level III