Gradual versus intermittent release of tourniquet in total knee arthroplasty surgery, effects on hemodynamics and acid base parameters: a prospective randomized controlled study | ||||
| Egyptian Journal of Anaesthesia | ||||
| Volume 37, Issue 1, January 2021, Page 234-240 PDF (2.16 MB) | ||||
| DOI: TEJA-2021-0028 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| Rania E. Elbadrawy; Mohamed A. Aboelela | ||||
| Abstract | ||||
| Background Using of the pneumatic tourniquet is a common practice in many surgeries. While it creates bloodless field, it is not free of complications. Tourniquet deflation is a critical stage, greatly affecting hemodynamics. Till now, no strict guidelines have been developed for managing such a procedure. Methods Sixty patients, >40 years old, undergoing total knee arthroplasty enrolled in this study. Tourniquet deflation done over 3 min before complete release, either by gradual pressure release 50 mmHg/30 s in gradual deflation (G) group or by three cycles of deflation-reinflation (deflation for 10 s and reinflation for 50 s) in intermittent deflation (I) group. Results No significant difference was found regarding patient demographics and basal data. Mean arterial pressure was significantly lower in G group at times of deflation and post deflation for 5 min ( values 0.011, 0.023, 0.024, 0.001, and 0.013, respectively). Also, heart rate and acid base parameters were more stable and convergent to basal data in I group. Conclusion Compared to gradual deflation, intermittent deflation of tourniquet in middle and old aged, total knee arthroplasty patients resulted in more stability in hemodynamics and acid base parameters. | ||||
| Keywords | ||||
| tourniquet; hemodynamics; acid base; pH; Lactate; knee arthroplasty | ||||
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