Anästhesie und klinische Forschung
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Abstrakt

Influence of Thigh Tourniquet Release on Cardiovascular Parameters While Operated Limb in Elevated Position

Ashraf A Mohamed and Hatem H Maghraby

Background: Release of pneumatic tourniquet causes hypotension, tachycardia and compensatory increase in cardiac index.

Objectives: This study was conducted to assess the effect of tourniquet release on cardiovascular parameters while operated leg in 20 degrees up position.

Design: Prospective randomized comparative study.

Setting: University hospital.

Methods: This study included 60 patients, ASA I scheduled for meniscal surgery through knee arthroscopy under general anesthesia. Patients were divided into two groups: group C (n=30) in which tourniquet was deflated with leg in neutral position while group S (n=30) tourniquet was released with leg in 20 degrees up position. Cardiovascular parameters displayed by ccNexfin monitor eg cardiac output (COP), cardiac index (CI), stroke volume (SV), mean arterial pressure (MAP), systemic vascular resistance (SVR), heart rate (HR), as well as arterial blood gas measurements. End tidal carbon dioxide, respiratory rate, end tidal sevoflurane and bispectral index values were also recorded before and after tourniquet deflation.

Results: There was significant decrease in MAP and SVR at all intervals post deflation in group C compared to group S whereas COP, CI, SV and HR were significantly increased in group C post deflation compared to group S. But there were no significant differences between groups regarding metabolic and respiratory parameters.

Conclusion: Tourniquet deflation while leg in elevated position caused attenuation in both the decrease in MAP, SVR and the compensatory increase in CI, COP and SV.

Limitations: This study is limited by its small sample size.