IN PROPERLY selected patients, the advent of hypotension as an adjunct to general anesthesia, by the use of ganglionic blocking agents, has added a unique physiologic advantage to various operative procedures without disproportionate hazard. There has been a long-standing need for this technique in excessively bloody, prolonged, and anatomically detailed and complicated operations in the head and neck. The decrease in oozing from capillaries, arterioles, and venules greatly facilitates surgical progress in the wound and permits a more detailed anatomical dissection in a shorter period. The dividends of such efficiency are better operations in less time with less blood loss.
Any significant alteration in basic physiologic function has a built-in risk, and this must be equated against the inherent advantages of the proposed change. The indications for hypotensive anesthesia automatically eliminate from consideration all operations that are simple, short, and in which there are no significant amounts of localized bleeding.