The effect of tourniquet deflation on hemodynamics and regional cerebral oxygen saturation in aged patients undergoing total knee replacement surgery
BackgroundInflation and deflation of a pneumatic tourniquet used in total knee replacement surgery induces various changes in patient's hemodynamic and metabolic status, which may result in serious complications, especially in aged patients. Near-infrared spectroscopy (NIRS) is a monitoring dev...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Society of Anesthesiologists
2012-11-01
|
| Series: | Korean Journal of Anesthesiology |
| Subjects: | |
| Online Access: | http://ekja.org/upload/pdf/kjae-63-425.pdf |
| _version_ | 1819230156995166208 |
|---|---|
| author | Inkyung Song Dong Yeon Kim Youn Jin Kim |
| author_facet | Inkyung Song Dong Yeon Kim Youn Jin Kim |
| author_sort | Inkyung Song |
| collection | DOAJ |
| description | BackgroundInflation and deflation of a pneumatic tourniquet used in total knee replacement surgery induces various changes in patient's hemodynamic and metabolic status, which may result in serious complications, especially in aged patients. Near-infrared spectroscopy (NIRS) is a monitoring device designed to estimate the regional cerebral oxygen saturation. We evaluated the effect of tourniquet deflation on hemodynamics and regional cerebral oxygen saturation in aged patients undergoing total knee replacement surgery, using NIRS.MethodsTwenty-eight American Society of Anesthesiologists physical status I or II patients, over the age of sixty-five years undergoing total knee replacement surgery, were included. Under general anesthesia, the mean arterial pressure (MAP), heart rate (HR), cardiac output (CO), stroke volume (SV), and regional cerebral oxygen saturation (rSO2) were recorded before induction of anesthesia and every 2 min after tourniquet deflation for 20 min. Arterial blood gas analysis was performed 5 min before, in addition to 0, and 10 min after tourniquet deflation.ResultsThe decrease of rSO2 was not significant during 20-min deflation period. MAP, CO and SV showed significant decrease during 2 to 12, 4 to 6 and 2 to 6-min period after tourniquet deflation, respectively (P < 0.05). There was no relationship between a maximal decrease of MAP and rSO2.ConclusionsIn aged patients undergoing total knee replacement surgery under general anesthesia, tourniquet deflation caused significant changes in hemodynamic and metabolic status, but not in regional cerebral oxygen saturation. It is recommended to monitor neurologic status, as well as hemodynamic and metabolic status to avoid serious complications, especially in aged patients. |
| first_indexed | 2024-12-23T11:24:36Z |
| format | Article |
| id | doaj.art-4e6c0360fc4c4b269f207e5d2f0d0988 |
| institution | Directory Open Access Journal |
| issn | 2005-6419 2005-7563 |
| language | English |
| last_indexed | 2024-12-23T11:24:36Z |
| publishDate | 2012-11-01 |
| publisher | Korean Society of Anesthesiologists |
| record_format | Article |
| series | Korean Journal of Anesthesiology |
| spelling | doaj.art-4e6c0360fc4c4b269f207e5d2f0d09882022-12-21T17:48:59ZengKorean Society of AnesthesiologistsKorean Journal of Anesthesiology2005-64192005-75632012-11-0163542543010.4097/kjae.2012.63.5.4257450The effect of tourniquet deflation on hemodynamics and regional cerebral oxygen saturation in aged patients undergoing total knee replacement surgeryInkyung Song0Dong Yeon Kim1Youn Jin Kim2Department of Anesthesiology and Pain Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.Department of Anesthesiology and Pain Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.Department of Anesthesiology and Pain Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.BackgroundInflation and deflation of a pneumatic tourniquet used in total knee replacement surgery induces various changes in patient's hemodynamic and metabolic status, which may result in serious complications, especially in aged patients. Near-infrared spectroscopy (NIRS) is a monitoring device designed to estimate the regional cerebral oxygen saturation. We evaluated the effect of tourniquet deflation on hemodynamics and regional cerebral oxygen saturation in aged patients undergoing total knee replacement surgery, using NIRS.MethodsTwenty-eight American Society of Anesthesiologists physical status I or II patients, over the age of sixty-five years undergoing total knee replacement surgery, were included. Under general anesthesia, the mean arterial pressure (MAP), heart rate (HR), cardiac output (CO), stroke volume (SV), and regional cerebral oxygen saturation (rSO2) were recorded before induction of anesthesia and every 2 min after tourniquet deflation for 20 min. Arterial blood gas analysis was performed 5 min before, in addition to 0, and 10 min after tourniquet deflation.ResultsThe decrease of rSO2 was not significant during 20-min deflation period. MAP, CO and SV showed significant decrease during 2 to 12, 4 to 6 and 2 to 6-min period after tourniquet deflation, respectively (P < 0.05). There was no relationship between a maximal decrease of MAP and rSO2.ConclusionsIn aged patients undergoing total knee replacement surgery under general anesthesia, tourniquet deflation caused significant changes in hemodynamic and metabolic status, but not in regional cerebral oxygen saturation. It is recommended to monitor neurologic status, as well as hemodynamic and metabolic status to avoid serious complications, especially in aged patients.http://ekja.org/upload/pdf/kjae-63-425.pdfagedhemodynamicsnear-infrared spectroscopytourniquet |
| spellingShingle | Inkyung Song Dong Yeon Kim Youn Jin Kim The effect of tourniquet deflation on hemodynamics and regional cerebral oxygen saturation in aged patients undergoing total knee replacement surgery Korean Journal of Anesthesiology aged hemodynamics near-infrared spectroscopy tourniquet |
| title | The effect of tourniquet deflation on hemodynamics and regional cerebral oxygen saturation in aged patients undergoing total knee replacement surgery |
| title_full | The effect of tourniquet deflation on hemodynamics and regional cerebral oxygen saturation in aged patients undergoing total knee replacement surgery |
| title_fullStr | The effect of tourniquet deflation on hemodynamics and regional cerebral oxygen saturation in aged patients undergoing total knee replacement surgery |
| title_full_unstemmed | The effect of tourniquet deflation on hemodynamics and regional cerebral oxygen saturation in aged patients undergoing total knee replacement surgery |
| title_short | The effect of tourniquet deflation on hemodynamics and regional cerebral oxygen saturation in aged patients undergoing total knee replacement surgery |
| title_sort | effect of tourniquet deflation on hemodynamics and regional cerebral oxygen saturation in aged patients undergoing total knee replacement surgery |
| topic | aged hemodynamics near-infrared spectroscopy tourniquet |
| url | http://ekja.org/upload/pdf/kjae-63-425.pdf |
| work_keys_str_mv | AT inkyungsong theeffectoftourniquetdeflationonhemodynamicsandregionalcerebraloxygensaturationinagedpatientsundergoingtotalkneereplacementsurgery AT dongyeonkim theeffectoftourniquetdeflationonhemodynamicsandregionalcerebraloxygensaturationinagedpatientsundergoingtotalkneereplacementsurgery AT younjinkim theeffectoftourniquetdeflationonhemodynamicsandregionalcerebraloxygensaturationinagedpatientsundergoingtotalkneereplacementsurgery AT inkyungsong effectoftourniquetdeflationonhemodynamicsandregionalcerebraloxygensaturationinagedpatientsundergoingtotalkneereplacementsurgery AT dongyeonkim effectoftourniquetdeflationonhemodynamicsandregionalcerebraloxygensaturationinagedpatientsundergoingtotalkneereplacementsurgery AT younjinkim effectoftourniquetdeflationonhemodynamicsandregionalcerebraloxygensaturationinagedpatientsundergoingtotalkneereplacementsurgery |