Techniques commonly used to minimize bleeding include but are not limited to topical decongestion, local injection of vasoconstrictors, maintaining normothermia, head elevation, and controlled hypotension. However, controlled hypotension is potentially a source of excessive vasodilatation and risk factor for ischemic events. In fact, a considerable amount of data has shown that the blood pressure and intraoperative bleeding are not necessarily related, and hypotension on its own does not necessarily improve the surgical field2, 3.