The effects of deliberate hypotension and normovolaemic haemodilution on operative blood loss were studied in patients undergoing hip arthroplasty. Thirty patients were anaesthetized with halothane-nitrous oxide, and assigned to one of three groups. In group I, mean arterial pressure was decreased to 55 mm Hg by sodium nitroprusside. In group II, 23 +/- 2 ml/kg of blood was withdrawn just before the surgical procedure and replaced by twice volume with 4% albumin and Ringer lactate solution. The shed blood was reinfused at the end of the surgical procedure. In group III, the blood replacement was equal to blood loss and this group served as control. Intraoperative blood losses were 1050 +/- 185 ml and 900 +/- 130 ml in the autotransfused and control groups, respectively, and 320 +/- ml in the hypotensive group. However, the total red cell loss was significantly less in the hypotensive and autotransfused groups than in the control group. No complications occurred any of the three groups. Deliberate hypotension was the most effective means of reducing intraoperative bleeding and the time for this procedure was shorter than for normovolaemic haemodilution combined with autotransfusion.

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Time for intubation, incidence of mechanical complications, occurrence of bacteraemia caused by intubation, and postoperative discomfort were assessed in relation to nasal and oral tracheal intubation in adult cardiac surgery. The time for placement of the tube was 2.5 times longer for nasal intubation. Nasal bleeding was observed in 45.3% of patients intubated through the nose. In patients in whom a naso-tracheal tube was passed, 9.4% (v. 2.3% of patients intubated via the mouth), exhibited positive blood cultures just after intubation; however, the difference was not significant. Postoperative discomfort was similar in both groups. It can be concluded that nasal tracheal intubation offers no advantage over oral tracheal intubation in adult cardiac surgery.

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