oa South African Medical Journal - Controlled hypotension in fenestration operations : experiences in twenty-seven cases



This communication is based on a small series of 27 cases in which hypotension was induced by hexamethonium bromide, sometimes aided by procaine amide, to procure a bloodless field for fenestration. Ligation, cautery, etc., is used for the soft-tissue work and hypotension is induced only at the critical stage when the labyrinth is opened and the danger of bleeding into the fenestra exists. As soon as the flap is applied and the fenestra is sealed off, the hypotensive process is reversed. Posture is used as an important adjunct and teamwork is essential for success. The dangers of thrombosis, failure of function or damage of vital organs, and reactionary haemorrhage, must be appreciated.


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