Safe use of induced hypotension in a patient with cirrhotic liver disease.

Induced hypotension was used in a patient with chronic active hepatitis and cirrhosis presenting for clipping of an intracranial aneurysm. A mean arterial pressure of 50 mmHg was produced with a combination of sodium nitroprusside and labetalol. The patient sustained no postoperative changes in hepatic function. Previous studies have examined the effects of induced hypotension on the function of the normal liver, but there is relatively little information available on its effects in the presence of liver disease. The lack of an adverse outcome in this patient does not prove the safety of this technique in patients with liver disease; further studies of this patient group are required.