Abstract
Controlled hypotension reduces blood loss during defined major surgical procedures, which in turn will minimize transfusion needs and thereby the risks of transmission of infectious diseases. There is no evidence that hypotension below 8 kPa (60 mmHg) (MAP) is associated with better blood-sparing effects than a more moderate hypotension, but it will probably increase the risk of cardiovascular complications. Therefore, controlled hypotension, being a sophisticated technique, requires handling by an experienced anesthetist well aware of contraindications and the need for adequate monitoring for prevention of tissue ischemia. Large randomized and prospective studies are still warranted, especially for further evaluation of the risk-benefit with controlled hypotension.