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June 1954


Author Affiliations

Department of Surgery (Anesthesiology), Stritch School of Medicine of Loyola University, and Mercy Hospital (Dr. Wyant).; From the Department of Surgery (Anesthesiology), University of Illinois College of Medicine, and the Research and Educational Hospitals (Drs. Sadove and Gleave).

AMA Arch Surg. 1954;68(6):779-786. doi:10.1001/archsurg.1954.01260050781007

THIMETHAPHAN camphorsulfonate (Arfonad) is the latest in a series of agents and techniques designed to lower blood pressure selectively and thus to reduce bleeding during surgical operations. Attempts to control bleeding are as old as surgery itself. Vasoconstrictor substances, tourniquets, manual compression and temporary occlusion of large vascular trunks, and deep anesthesia are only a few of the methods which have at one time or another been employed. However, only in recent years has it become possible to approach solution of this problem by the deliberate induction of circulatory hypotension, unattended by the feared hazards of a shock-like state. In the last few years, efforts have been concentrated upon improving both controllability and reversibility of such induced hypotension, thus increasing the over-all safety of the method,

INDUCED HYPOTENSION AND SHOCK  Before discussing the various aspects of induced hypotension, it is well to review briefly the physiopathological basis of the more

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