Introduction:

Controlled hypotension implies any technique that, used alone or in combination, intentionally lowers blood pressure values during the intraoperative period, in order to reduce bleeding and improve the visibility of the surgical field.

Objective:

To describe the physiological foundations, definitions, techniques and complications of controlled hypotension in spinal surgery.

Methods:

A literature review was carried out in scientific databases such as Cochrane Database of Systematic Reviews, Pubmed/Medline, EMBASE, SCOPUS, Web of Science, Ebsco Host, ScienceDirect, OVID and the academic search engine Google Scholar, in June 2020.

Conclusion:

Controlled hypotension in spinal surgery has limited surgical benefits. However, there is no precise consensus on the hemodynamic thresholds and time limits required for its use, and it is associated with a high risk of potential complications as delirium, postoperative cognitive dysfunction, ischemic stroke, postoperative visual loss, acute kidney injury, myocardial injury, late postoperative neurological deficit and chronic neuropathic pain; therefore, its routine use during the intraoperative period is not recommended.

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