{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:44:19Z","timestamp":1760132659087,"version":"3.40.5"},"reference-count":48,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,2,9]],"date-time":"2022-02-09T00:00:00Z","timestamp":1644364800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the efficacy and safety of hypotensive anesthesia (HA) combined with tranexamic acid (TXA) for reducing perioperative blood loss in simultaneous bilateral total hip arthroplasty (SBTHA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this retrospective cohort study, a total of 183 eligible patients (15 females and 168 males, 44.01\u2009\u00b1\u20099.29\u2009years old) who underwent SBTHA from January 2015 to September 2020 at our medical center were enrolled for analysis. Fifty\u2010nine patients received standard general anesthesia (Std\u2010GA group), the other 85 and 39 patients received HA with an intraoperative mean arterial pressure between 70 and 80\u2009mmHg (70\u201380 HA group) and below 70\u2009mmHg (&lt;70 HA group), respectively. TXA was administrated to all patients. Perioperative blood loss (total, dominant, and hidden), transfusion rate and volume, hemoglobin and hematocrit reduction, duration of operation and anesthesia, length of hospitalization, range of hip motion as well as postoperative complications were collected from hospital's electronic records and compared between groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All patients were followed for more than 3\u2009months. Total blood loss in the two HA groups (1390.25\u2009\u00b1\u2009595.67 ml and 1377.74\u2009\u00b1\u2009423.46 ml, respectively) was significantly reduced compared with that in Std\u2010GA group (1850.83\u2009\u00b1\u2009800.73 ml, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Both dominant and hidden blood loss were dramatically decreased when HA was applied (both <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Accordingly, the transfusion rate along with volume in 70\u201380 HA group (14.1%, 425.00\u2009\u00b1\u2009128.81 ml) and\u2009&lt;70 HA group (12.8%, 340.00\u2009\u00b1\u2009134.16 ml) were reduced in comparison with those in Std\u2010GA group (37.3%, 690.91\u2009\u00b1\u2009370.21ml; <jats:italic>P\u2009=<\/jats:italic>\u00a00.001 and <jats:italic>P\u2009=<\/jats:italic>\u00a00.014, respectively). The maximal hemoglobin and hematocrit reduction in both HA groups were significantly less than those in Std\u2010GA group (both <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Of note, 70\u201380 and\u2009&lt;70 HA groups exhibited comparable efficacy with no significant differences between them. Besides, significant difference in duration of surgery was found among groups (<jats:italic>P\u2009=<\/jats:italic>\u00a00.044 and <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), while no differences in anesthesia time and postoperative range of hip motion were observed. Regarding complications, the incidence of both acute kidney injury and postoperative hypotension in &lt;70 HA group was significantly higher than that in 70\u201380 HA and Std\u2010GA groups (<jats:italic>P\u2009=<\/jats:italic>\u00a00.014 and <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Incidence of acute myocardial injury was similar among groups (<jats:italic>P\u2009=<\/jats:italic>\u00a00.099) and no other severe complications or mortality were recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The combination of HA with a mean arterial pressure (MAP) of 70\u201380\u2009mmHg and TXA could significantly reduce blood loss and transfusion during SBTHA, in addition to shortening operation time and length of hospitalization, and with no increase in complications.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.13200","type":"journal-article","created":{"date-parts":[[2022,2,10]],"date-time":"2022-02-10T02:20:17Z","timestamp":1644459617000},"page":"555-565","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Hypotensive Anesthesia Combined with Tranexamic Acid Reduces Perioperative Blood Loss in Simultaneous Bilateral Total Hip Arthroplasty: A Retrospective Cohort Study"],"prefix":"10.1111","volume":"14","author":[{"given":"Qing\u2010Yi","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Orthopedic Research Institute and National Clinical Research Center for Geriatrics West China Hospital, Sichuan University  Chengdu China"},{"name":"Laboratory of Stem Cell and Tissue Engineering Orthopedic Research Institute, West China Hospital, Sichuan University  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kai","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Orthopedic Research Institute and National Clinical Research Center for Geriatrics West China Hospital, Sichuan University  Chengdu China"},{"name":"Laboratory of Stem Cell and Tissue Engineering Orthopedic Research Institute, West China Hospital, Sichuan University  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shi\u2010Jiu","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Orthopedic Research Institute and National Clinical Research Center for Geriatrics West China Hospital, Sichuan University  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mi\u2010Ye","family":"Wang","sequence":"additional","affiliation":[{"name":"Information Center of West China Hospital Sichuan University  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ren","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology West China Hospital, Sichuan University  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui\u2010Qi","family":"Xie","sequence":"additional","affiliation":[{"name":"Laboratory of Stem Cell and Tissue Engineering Orthopedic Research Institute, West China Hospital, Sichuan 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