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The Impact of Blood Pressure Switching (from Controlled Hypotension to Late Elevated Blood Pressure) During Laparoscopic Sleeve Gastrectomy: Controlled Clinical Trial

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Abstract

Purpose

Laparoscopic sleeve gastrectomy (LSG) is the most done bariatric procedure. Bleeding and leak are the most common associated complications. Elevation of systolic blood pressure (SBP) leads to discovering the bleeding sites but results in a bloody field and increases the operative time. Controlled hypotension shortens the operative time, reduces tissue edema, and improves field vision. We aimed to test controlled hypotension during LSG.

Material and Methods

This was a randomized controlled trial that included 200 patients who were operated by LSG, randomly assigned to 2 equal groups: group 1, operated with controlled hypotensive anesthesia, and group 2, operated with elevated SBP to 140 mmHg.

Results

Of the patients, 162 (81%) were females, and 38 (19%) were male. The mean BMI was 45.7 kg/m2. The mean age was 41.7 years. The operative time was 36.43 ± 6.73 min in group 1 vs. 44.71 ± 5.47 min in group 2. The mean of total number of used gauzes and clips was 2.70 ± 3.49 in group 1 vs. 8.83 ± 3.15 in group 2. The mean amount of drain output was 37.65 ± 21.90 ml in group 1 vs. 74.00 ± 16.54 ml in group 2. The mean drop in the postoperative hematocrit was 0.08 in group 1 vs. 0.22 in group 2. The incidence of postoperative bleeding was 0% in group 1 vs. 1% in group 2.

Conclusions

Controlled hypotensive anesthesia in LSG reduces the operative time, reduces the intraoperative bleeding, and improves the operative field.

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Authors and Affiliations

  1. Department of Surgery, Minia University Hospital, Minia, Egypt

    Alaa M. Sewefy & Ahmed M. Atyia

  2. Faculty of Medicine, Ain Shams University, Ain Shams, Egypt

    Karim Sabry

  3. Department of Anesthesia, Minia University Hospital, Minia, Egypt

    Hassan M Hetta

Authors
  1. Alaa M. Sewefy
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  2. Karim Sabry
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  3. Hassan M Hetta
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  4. Ahmed M. Atyia
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Contributions

Alaa M. Sewefy: Put the idea of the research, operated the cases, and wrote the manuscript. Karim Sabry: Collected data, wrote, and reviewed the manuscript. Hassan M Hetta: Anesthetized the cases, collected data, wrote, and reviewed the manuscript. Ahmed M. Atyia: Collected data, wrote, and reviewed the manuscript.

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Correspondence to Alaa M. Sewefy.

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Sewefy, A.M., Sabry, K., Hetta, H.M. et al. The Impact of Blood Pressure Switching (from Controlled Hypotension to Late Elevated Blood Pressure) During Laparoscopic Sleeve Gastrectomy: Controlled Clinical Trial. OBES SURG 33, 2602–2607 (2023). https://doi.org/10.1007/s11695-023-06699-9

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  • DOI: https://doi.org/10.1007/s11695-023-06699-9

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