Tourniquet release: systemic and metabolic effects

The pneumatic tourniquet produces ischemic changes in limbs. The effects of tourniquet release on systemic blood pressure and metabolic parameters were studied in 11 adult patients undergoing total knee replacement under general anesthesia. Mean arterial pressure (MAP) decreased rapidly after the re...

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Bibliographic Details
Published inActa anaesthesiologica Scandinavica Vol. 40; no. 10; p. 1234
Main Authors Townsend, H S, Goodman, S B, Schurman, D J, Hackel, A, Brock-Utne, J G
Format Journal Article
LanguageEnglish
Published England 01.11.1996
Subjects
Adult
Aged
Aged, 80 and over
Anesthesia, General
Blood Pressure
Carbon Dioxide - blood
Humans
Hydrogen-Ion Concentration
Knee Prosthesis
Middle Aged
Respiration, Artificial
Tourniquets
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Summary:The pneumatic tourniquet produces ischemic changes in limbs. The effects of tourniquet release on systemic blood pressure and metabolic parameters were studied in 11 adult patients undergoing total knee replacement under general anesthesia. Mean arterial pressure (MAP) decreased rapidly after the release of the tourniquet, becoming significant at 3 min and remaining significantly depressed up to 15 min post release. Arterial pH, PaO2, PaCO2, lactate acid, and potassium changed significantly after the release, but normalized within 30 min. These results are notably different from a previous study in a similar patient population undergoing knee replacement under epidural anesthesia. Compared to patients under epidural anesthesia, patients receiving general anesthesia with mechanical ventilation are unable to compensate for the metabolic load caused by the tourniquet release, as the latter group are unable to alter their ventilatory rate. In elderly patients with decreased cardio-pulmonary reserve, this may be of clinical importance.
ISSN:0001-5172
DOI:10.1111/j.1399-6576.1996.tb05556.x