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Abstract
Controlled hypotension is used to reduce intraoperative bleeding and to provide a satisfactory surgical field exposure. So, it is widely used in oro-maxillo-facial surgeries, endoscopic sinus surgeries, middle ear microsurgeries, spine surgeries, some neurosurgeries, major orthopedic surgeries and cancer surgeries. Several clinical trials were conducted to assess the efficacy of different techniques and pharmaceuticals in producing controlled hypotensive anesthesia as neuroaxial anesthesia direct vasodilators, beta blockers, alpha 2 adrenergic agonists, and calcium channel blockers