Effects of Four Anesthesia Methods and Tourniquet Durations on Tourniquet Induced Hypertension during Total Knee Arthroplasty.
10.4097/kjae.2002.42.3.312
- Author:
Mi Ae CHEONG
1
;
Myoung Soo KOH
;
Hong Seuk YANG
Author Information
1. Department of Anesthesiology, College of Medicine, Hanyang University, Seoul, Korea. hsyang@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Epidural anesthesia;
inhalation anesthesia;
spinal anesthesia;
tourniquets-induced hypertension
- MeSH:
Anesthesia*;
Anesthesia, Epidural;
Anesthesia, General;
Anesthesia, Inhalation;
Anesthesia, Spinal;
Arterial Pressure;
Arthroplasty*;
Extremities;
Heart Rate;
Hemodynamics;
Hemorrhage;
Humans;
Hypertension*;
Incidence;
Inflation, Economic;
Knee*;
Tourniquets*
- From:Korean Journal of Anesthesiology
2002;42(3):312-317
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: A tourniquet is often used during limb surgery to minimize surgical bleeding and to keep the clear surgical field. However the tourniquet is associated with severe hemodynamic changes and tourniquet-induced hypertension. We investigated the incidences of tourniquet-induced hypertension by tourniquet duration and anesthetic methods. METHODS: One hundred thirteen patients who underwent a total knee arthroplasty were assigned into four groups according to the types of anesthesia; general anesthesia (group I, n = 30), general anesthesia and intravenous adjuvants (group II, n = 30), general and epidural anesthesia (group III, n = 22), and spinal anesthesia (group IV, n = 31). Mean arterial pressure and heart rate were recorded at ward, before induction, one minute after tourniquet inflation and every 10 minutes until 60 mininutes. The extremity was exsanguinated and a tourniquet pressure of 350 mmHg (9 cm width) was applied in all groups. RESULTS: The mean arterial pressure increased in group I and II during the tourniquet inflation period. The incidence of tourniquet-induced hypertension was higher in group I (6.7%) than other groups but there was no statistical significance among the groups. Heart rates were not changed in any groups. CONCLUSIONS: We concluded that the shorter the tourniquet time the less the occurrence of tourniquet-induced hypertension under any type of anesthesia.
