Controlled Hypotension Target — FRCA Final MCQ

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ModerateGeneral AnaesthesiaControlled Hypotension TargetFRCA Final

A 38-year-old man (ASA I) is scheduled for a septoplasty. The surgeon requests hypotensive anaesthesia to reduce bleeding in the surgical field. What is the target mean arterial pressure for controlled hypotension?

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Correct answer: E — MAP 50-65 mmHg or 30% below baseline

Controlled hypotension aims for a MAP of 50-65 mmHg or a reduction of approximately 30% from the patient's baseline MAP. This reduces capillary bleeding in the surgical field, improving visibility. The technique requires careful monitoring (invasive BP, ETCO2, urine output) and is achieved using remifentanil, beta-blockers, GTN, or deepening volatile anaesthesia. Contraindications include cerebrovascular disease, severe ischaemic heart disease, renal impairment, and uncontrolled hypertension. Head-up positioning assists by reducing venous pressure.

Reference: RCOA – 2023 – Head and neck anaesthesia module; AAGBI – 2020 – Monitoring standards