Hypotensive anaesthesia for craniectomy in infancy.

Deliberate hypotension using halothane and controlled ventilation without positive end-expiratory pressure was employed in 18 of 30 patients undergoing craniectomy for unilateral or bilateral craniosynostosis over a 3-yr period. The technique was simple, resulted in good control of arterial pressure and diminished blood loss, and did not involve extensive monitoring or the use of potentially toxic adjuvant drugs. In the hypotensive group mean systolic arterial pressure was decreased from 92.5 to 65.0 mm Hg. Estimated blood loss was decreased from 111 to 89 ml (mean) for all ages and from 133 to 72 ml (mean) for infants between 8 and 32 weeks of age compared with the normotensive control group.