Finding the optimal control level of intraoperative blood pressure in no tourniquet primary total knee arthroplasty combine with tranexamic acid: a retrospective cohort study which supports the enhanced recovery strategy
Abstract Background With the use of tranexamic acid and control of the blood pressure during the operation, total knee arthroplasty (TKA) without tourniquet can be achieved. There is no exact standard for the control level of blood pressure during no tourniquet TKA. We explored the optimal level of...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-08-01
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| Series: | Journal of Orthopaedic Surgery and Research |
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| Online Access: | http://link.springer.com/article/10.1186/s13018-020-01887-0 |
| _version_ | 1818037089752580096 |
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| author | Hao-Yang Wang Ming-cheng Yuan Fu-Xing Pei Zong-Ke Zhou Ren Liao |
| author_facet | Hao-Yang Wang Ming-cheng Yuan Fu-Xing Pei Zong-Ke Zhou Ren Liao |
| author_sort | Hao-Yang Wang |
| collection | DOAJ |
| description | Abstract Background With the use of tranexamic acid and control of the blood pressure during the operation, total knee arthroplasty (TKA) without tourniquet can be achieved. There is no exact standard for the control level of blood pressure during no tourniquet TKA. We explored the optimal level of blood pressure control during no tourniquet TKA surgery with the use of tranexamic acid in this study. Methods Patients underwent TKA were divided into three groups: the mean intraoperative systolic blood pressure in group A was < 90 mmHg, 90–100 mmHg in group B, > 100 mmHg in group C. Total blood loss (TBL), intraoperative blood loss, hidden blood loss, transfusion rate, maximum hemoglobin drop, operation time, and postoperative hospitalization days were recorded. Results Two hundred seventy-eight patients were enrolled, 82 in group A, 105 in group B, and 91 in group C. Group A (663.3 ± 46.0 ml) and group B (679.9 ± 57.1 ml) had significantly lower TBL than group C (751.7 ± 56.2 ml). Group A (120.2 ± 18.7 ml) had the lowest intraoperative blood loss than groups B and C. Group C (26.0 ± 4.1 g/l) had the largest Hb change than groups A and B. Group A (62.3 ± 4.7 min) had the shortest operation time. The incidence rate of postoperative hypotension in group A (8, 9.8%) was significantly greater than groups B and C. No significant differences were found in other outcomes. Conclusion The systolic blood pressure from 90 to 100 mmHg was the optimal strategy for no tourniquet primary TKA with tranexamic acid. |
| first_indexed | 2024-12-10T07:21:18Z |
| format | Article |
| id | doaj.art-3026809a6a654304b5efa871a5b700aa |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-12-10T07:21:18Z |
| publishDate | 2020-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-3026809a6a654304b5efa871a5b700aa2022-12-22T01:57:49ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2020-08-011511910.1186/s13018-020-01887-0Finding the optimal control level of intraoperative blood pressure in no tourniquet primary total knee arthroplasty combine with tranexamic acid: a retrospective cohort study which supports the enhanced recovery strategyHao-Yang Wang0Ming-cheng Yuan1Fu-Xing Pei2Zong-Ke Zhou3Ren Liao4Department of Orthopedics, West China Hospital/West China School of Medicine, Sichuan UniversityDepartment of Orthopedics, West China Hospital/West China School of Medicine, Sichuan UniversityDepartment of Orthopedics, West China Hospital/West China School of Medicine, Sichuan UniversityDepartment of Orthopedics, West China Hospital/West China School of Medicine, Sichuan UniversityDepartment of Anesthesiology, West China Hospital/West China School of Medicine, Sichuan UniversityAbstract Background With the use of tranexamic acid and control of the blood pressure during the operation, total knee arthroplasty (TKA) without tourniquet can be achieved. There is no exact standard for the control level of blood pressure during no tourniquet TKA. We explored the optimal level of blood pressure control during no tourniquet TKA surgery with the use of tranexamic acid in this study. Methods Patients underwent TKA were divided into three groups: the mean intraoperative systolic blood pressure in group A was < 90 mmHg, 90–100 mmHg in group B, > 100 mmHg in group C. Total blood loss (TBL), intraoperative blood loss, hidden blood loss, transfusion rate, maximum hemoglobin drop, operation time, and postoperative hospitalization days were recorded. Results Two hundred seventy-eight patients were enrolled, 82 in group A, 105 in group B, and 91 in group C. Group A (663.3 ± 46.0 ml) and group B (679.9 ± 57.1 ml) had significantly lower TBL than group C (751.7 ± 56.2 ml). Group A (120.2 ± 18.7 ml) had the lowest intraoperative blood loss than groups B and C. Group C (26.0 ± 4.1 g/l) had the largest Hb change than groups A and B. Group A (62.3 ± 4.7 min) had the shortest operation time. The incidence rate of postoperative hypotension in group A (8, 9.8%) was significantly greater than groups B and C. No significant differences were found in other outcomes. Conclusion The systolic blood pressure from 90 to 100 mmHg was the optimal strategy for no tourniquet primary TKA with tranexamic acid.http://link.springer.com/article/10.1186/s13018-020-01887-0Controlled intraoperative hypotensionTranexamic acidTourniquetEnhanced recovery |
| spellingShingle | Hao-Yang Wang Ming-cheng Yuan Fu-Xing Pei Zong-Ke Zhou Ren Liao Finding the optimal control level of intraoperative blood pressure in no tourniquet primary total knee arthroplasty combine with tranexamic acid: a retrospective cohort study which supports the enhanced recovery strategy Journal of Orthopaedic Surgery and Research Controlled intraoperative hypotension Tranexamic acid Tourniquet Enhanced recovery |
| title | Finding the optimal control level of intraoperative blood pressure in no tourniquet primary total knee arthroplasty combine with tranexamic acid: a retrospective cohort study which supports the enhanced recovery strategy |
| title_full | Finding the optimal control level of intraoperative blood pressure in no tourniquet primary total knee arthroplasty combine with tranexamic acid: a retrospective cohort study which supports the enhanced recovery strategy |
| title_fullStr | Finding the optimal control level of intraoperative blood pressure in no tourniquet primary total knee arthroplasty combine with tranexamic acid: a retrospective cohort study which supports the enhanced recovery strategy |
| title_full_unstemmed | Finding the optimal control level of intraoperative blood pressure in no tourniquet primary total knee arthroplasty combine with tranexamic acid: a retrospective cohort study which supports the enhanced recovery strategy |
| title_short | Finding the optimal control level of intraoperative blood pressure in no tourniquet primary total knee arthroplasty combine with tranexamic acid: a retrospective cohort study which supports the enhanced recovery strategy |
| title_sort | finding the optimal control level of intraoperative blood pressure in no tourniquet primary total knee arthroplasty combine with tranexamic acid a retrospective cohort study which supports the enhanced recovery strategy |
| topic | Controlled intraoperative hypotension Tranexamic acid Tourniquet Enhanced recovery |
| url | http://link.springer.com/article/10.1186/s13018-020-01887-0 |
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