Measurement of tissue oxygen saturation during arthroscopic surgery of knee with a tourniquet
Abstract Background Tourniquets provide better tissue visibility during arthroscopic surgery. However, multiple postoperative adverse events associated with ischemia may be caused by excessive inflation pressure and duration. We aimed to evaluate the degree of tourniquet-induced ischemia using a non...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-12-01
|
| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-022-03431-8 |
| _version_ | 1811188194526363648 |
|---|---|
| author | Ning Hao Mengxue Cui Yongyong Shi Zitao Liu Xiangyu Li Yansheng Chen Gaofeng Zhao |
| author_facet | Ning Hao Mengxue Cui Yongyong Shi Zitao Liu Xiangyu Li Yansheng Chen Gaofeng Zhao |
| author_sort | Ning Hao |
| collection | DOAJ |
| description | Abstract Background Tourniquets provide better tissue visibility during arthroscopic surgery. However, multiple postoperative adverse events associated with ischemia may be caused by excessive inflation pressure and duration. We aimed to evaluate the degree of tourniquet-induced ischemia using a noninvasive continuous real-time monitoring method and the relationship between changes in tissue oxygen saturation (StO2) and blood biochemical markers of ischemic injuries in patients undergoing arthroscopic knee surgery. Methods This was a prospective observational study using near-infrared spectroscopy (NIRS). Data were collected from 29 consecutive patients who underwent arthroscopic procedures. Twenty-five patients underwent anterior cruciate ligament reconstruction, and four underwent meniscal repair. We investigated tourniquet‐induced changes in StO2, monitored using NIRS, and blood biochemical markers of ischemic injuries. Results A significant decrease in the mean StO2 from the baseline was observed during tourniquet inflation in the operative legs. The average decrease in the mean StO2 was 58%. A comparison of mean StO2 between the nonoperative and operative legs before tourniquet deflation showed that mean values of StO2 in the operative legs were significantly lower than those in the nonoperative legs. No significant clinical relationships were observed between changes in StO2 and blood biochemical markers of ischemic injuries (creatine kinase) (p = 0.04, r = 0.38) or tourniquet duration (p = 0.05, r = 0.366). Conclusions Our results demonstrated that StO2 could be used to evaluate tissue perfusion in real time but did not support the hypothesis that StO2 is a useful method for predicting the degree of tourniquet-induced injury during arthroscopic knee surgery. |
| first_indexed | 2024-04-11T14:15:26Z |
| format | Article |
| id | doaj.art-1d4bfc2a13fb4c69aa78dd4299ddd754 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T14:15:26Z |
| publishDate | 2022-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-1d4bfc2a13fb4c69aa78dd4299ddd7542022-12-22T04:19:25ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2022-12-011711610.1186/s13018-022-03431-8Measurement of tissue oxygen saturation during arthroscopic surgery of knee with a tourniquetNing Hao0Mengxue Cui1Yongyong Shi2Zitao Liu3Xiangyu Li4Yansheng Chen5Gaofeng Zhao6The Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhou University of Chinese MedicineThe Second Affiliated Hospital of Guangzhou University of Chinese MedicineDepartment of Orthopaedics, The Second Affiliated Hospital of Guangzhou University of Chinese MedicineThe Second Affiliated Hospital of Guangzhou University of Chinese MedicineThe Second Affiliated Hospital of Guangzhou University of Chinese MedicineThe Second Affiliated Hospital of Guangzhou University of Chinese MedicineAbstract Background Tourniquets provide better tissue visibility during arthroscopic surgery. However, multiple postoperative adverse events associated with ischemia may be caused by excessive inflation pressure and duration. We aimed to evaluate the degree of tourniquet-induced ischemia using a noninvasive continuous real-time monitoring method and the relationship between changes in tissue oxygen saturation (StO2) and blood biochemical markers of ischemic injuries in patients undergoing arthroscopic knee surgery. Methods This was a prospective observational study using near-infrared spectroscopy (NIRS). Data were collected from 29 consecutive patients who underwent arthroscopic procedures. Twenty-five patients underwent anterior cruciate ligament reconstruction, and four underwent meniscal repair. We investigated tourniquet‐induced changes in StO2, monitored using NIRS, and blood biochemical markers of ischemic injuries. Results A significant decrease in the mean StO2 from the baseline was observed during tourniquet inflation in the operative legs. The average decrease in the mean StO2 was 58%. A comparison of mean StO2 between the nonoperative and operative legs before tourniquet deflation showed that mean values of StO2 in the operative legs were significantly lower than those in the nonoperative legs. No significant clinical relationships were observed between changes in StO2 and blood biochemical markers of ischemic injuries (creatine kinase) (p = 0.04, r = 0.38) or tourniquet duration (p = 0.05, r = 0.366). Conclusions Our results demonstrated that StO2 could be used to evaluate tissue perfusion in real time but did not support the hypothesis that StO2 is a useful method for predicting the degree of tourniquet-induced injury during arthroscopic knee surgery.https://doi.org/10.1186/s13018-022-03431-8Tissue oxygen saturationTourniquetIschemic injury |
| spellingShingle | Ning Hao Mengxue Cui Yongyong Shi Zitao Liu Xiangyu Li Yansheng Chen Gaofeng Zhao Measurement of tissue oxygen saturation during arthroscopic surgery of knee with a tourniquet Journal of Orthopaedic Surgery and Research Tissue oxygen saturation Tourniquet Ischemic injury |
| title | Measurement of tissue oxygen saturation during arthroscopic surgery of knee with a tourniquet |
| title_full | Measurement of tissue oxygen saturation during arthroscopic surgery of knee with a tourniquet |
| title_fullStr | Measurement of tissue oxygen saturation during arthroscopic surgery of knee with a tourniquet |
| title_full_unstemmed | Measurement of tissue oxygen saturation during arthroscopic surgery of knee with a tourniquet |
| title_short | Measurement of tissue oxygen saturation during arthroscopic surgery of knee with a tourniquet |
| title_sort | measurement of tissue oxygen saturation during arthroscopic surgery of knee with a tourniquet |
| topic | Tissue oxygen saturation Tourniquet Ischemic injury |
| url | https://doi.org/10.1186/s13018-022-03431-8 |
| work_keys_str_mv | AT ninghao measurementoftissueoxygensaturationduringarthroscopicsurgeryofkneewithatourniquet AT mengxuecui measurementoftissueoxygensaturationduringarthroscopicsurgeryofkneewithatourniquet AT yongyongshi measurementoftissueoxygensaturationduringarthroscopicsurgeryofkneewithatourniquet AT zitaoliu measurementoftissueoxygensaturationduringarthroscopicsurgeryofkneewithatourniquet AT xiangyuli measurementoftissueoxygensaturationduringarthroscopicsurgeryofkneewithatourniquet AT yanshengchen measurementoftissueoxygensaturationduringarthroscopicsurgeryofkneewithatourniquet AT gaofengzhao measurementoftissueoxygensaturationduringarthroscopicsurgeryofkneewithatourniquet |