TITLE

The effect of tourniquet deflation on hemodynamics and regional cerebral oxygen saturation in aged patients undergoing total knee replacement surgery

AUTHOR(S)
Inkyung Song; Dong Yeon Kim; Youn Jin Kim
PUB. DATE
November 2012
SOURCE
Korean Journal of Anesthesiology;Nov2012, Vol. 63 Issue 5, p425
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Inflation and deflation of a pneumatic tourniquet used in total knee replacement surgery induces various changes in patient's hemodynamic and metabolic status, which may result in serious complications, especially in aged patients. Near-infrared spectroscopy (NIRS) is a monitoring device designed to estimate the regional cerebral oxygen saturation. We evaluated the effect of tourniquet deflation on hemodynamics and regional cerebral oxygen saturation in aged patients undergoing total knee replacement surgery, using NIRS. Methods: Twenty-eight American Society of Anesthesiologists physical status I or II patients, over the age of sixtyfive years undergoing total knee replacement surgery, were included. Under general anesthesia, the mean arterial pressure (MAP), heart rate (HR), cardiac output (CO), stroke volume (SV), and regional cerebral oxygen saturation (rSO2) were recorded before induction of anesthesia and every 2 min after tourniquet deflation for 20 min. Arterial blood gas analysis was performed 5 min before, in addition to 0, and 10 min after tourniquet deflation. Results: The decrease of rSO2 was not significant during 20-min deflation period. MAP, CO and SV showed significant decrease during 2 to 12, 4 to 6 and 2 to 6-min period after tourniquet deflation, respectively (P < 0.05). There was no relationship between a maximal decrease of MAP and rSO2. Conclusions: In aged patients undergoing total knee replacement surgery under general anesthesia, tourniquet deflation caused significant changes in hemodynamic and metabolic status, but not in regional cerebral oxygen saturation. It is recommended to monitor neurologic status, as well as hemodynamic and metabolic status to avoid serious complications, especially in aged patients.
ACCESSION #
88001158

 

Related Articles

  • The effects of a pneumatic tourniquet on blood loss in total knee arthroplasty. Tetro, A. Mark; Rudan, John F. // Canadian Journal of Surgery;Feb2001, Vol. 44 Issue 1, p33 

    Reports the effects of pneumatic tourniquet on blood loss in total knee arthroplasty. Risks associated with the use of tourniquets; Measurements on blood loss and calculations; Recommendation to implant survival or benefits to cementing techniques.

  • Total knee arthroplasty-what do we know and what don't. Becker, R. // Knee Surgery, Sports Traumatology, Arthroscopy;Jul2011, Vol. 19 Issue 7, p1051 

    An introduction to the journal is presented in which the author cites the number of publications about total knee arthroplasty (TKA), and discusses the articles published within the issue including one on the use of tourniquet in TKA and another on femoral component rotation in TKA.

  • Tourniquet Use During Total Knee Arthroplasty Did Not Reduce Total Blood Loss. Tetro, A.M.; Rudan, J.F. // Journal of Bone & Joint Surgery, American Volume;Aug2001, Vol. 83-A Issue 8, p1282 

    Question: In patients having cemented total knee arthroplasty, how effective is the use of tourniquets in preventing blood loss? Design: Randomized (allocation concealed), unblinded, controlled trial with 7-day follow-up. Setting: A hospital in Kingston, Ontario, Canada. Patients: 63 patients...

  • Comparison of arterial lactate levels during sevoflurane versus spinal anesthesia in elderly females undergoing total knee arthroplasty. Park, Hee; Lee, Kyung; Son, Woon; Lee, Ji; Jo, Youn // Journal of Anesthesia;Apr2014, Vol. 28 Issue 2, p294 

    Prolonged tourniquet inflation during total knee arthroplasty (TKR) could lead to ischemic muscle injury. The aim of this study was to investigate the effects of spinal and sevoflurane anesthesia on arterial lactate levels, acid-base status, and on hemodynamic variables in elderly women...

  • Einfluss der Blutleere auf den perioperativen Blutverlust nach Knietotalendoprothesenimplantation. Matziolis, D.; Perka, C.; Hube, R.; Matziolis, G. // Der Orthopäde;Feb2011, Vol. 40 Issue 2, p178 

    The purpose of this study was to evaluate the effect of tourniquet use with constant pressure until wound closure on perioperative blood loss in total knee arthroplasty (TKA). Sufficient patients were included in the study to produce statistically relevant conclusions. In this retrospective case...

  • Effect of Combined Spinal-epidural Versus General Anesthesia on the Hemodynamic, Respiratory and Metabolic Changes Associated with Tourniquet Deflation. Grinberg, D.; Izakson, A.; Dimitrochenko, V.; Yakobashvili, S.; Ezri, T.; Feldbrin, Z. // Acta Medica Marisiensis;Dec2010, Vol. 56 Issue 6, p505 

    Background: Tourniquet deflation is associated with profound hemodynamic, respiratory and other organ system derangements. These changes occur with both general and regional anesthesia. Since general and regional anesthesia impact the cardiovascular systems in different ways, we found it...

  • The Influence of Tourniquet Use and Timing of its Release on Blood Loss in Total Knee Arthroplasty. Yavarikia, A.; Amjad, G. G.; Davoudpour, K. // Pakistan Journal of Biological Sciences;2010, Vol. 13 Issue 5, p249 

    In surgical practice, hemostasis is used to minimize postoperative bleeding in total knee arthroplasty. We performed a prospective randomized study to determine the influence of tourniquet use and the timing of its release on amount of bleeding. Eighty four patients (96 knees) were scheduled for...

  • Tourniquet use in total knee arthroplasty: a meta-analysis. Ta-Wei Tai; Chii-Jeng Lin; I-Ming Jou; Chih-Wei Chang; Kuo-An Lai; Chyun-Yu Yang // Knee Surgery, Sports Traumatology, Arthroscopy;Jul2011, Vol. 19 Issue 7, p1121 

    Purpose: The use of an intraoperative tourniquet for total knee arthroplasty (TKA) is a common practice. However, the effectiveness and safety are still questionable. A systematic review was conducted to examine that whether using a tourniquet in TKA was effective without increasing the risk of...

  • Timing of tourniquet removal after knee replacement. Newman, J. H.; Jackson, J. P.; Waugh Mchir, W. // Journal of the Royal Society of Medicine;Jul1979, Vol. 72 Issue 7, p492 

    The article discusses research on the timing of the removal of the tourniquet on patients after a knee replacement surgery. The study aims to identify a prospective trial in order to determine whether it is better to remove the tourniquet before the wound closes or to leave it on until...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics