Korean J Intern Med.  2010 Mar;25(1):105-109. 10.3904/kjim.2010.25.1.105.

A Case of Rhabdomyolysis Associated with Use of a Pneumatic Tourniquet during Arthroscopic Knee Surgery

• Lee YG
• Park W
• Kim SH
• Yun SP
• Jeong H
• Kim HJ
• Yang DH

• KMID: 1785663
• DOI: http://doi.org/10.3904/kjim.2010.25.1.105

Abstract

The common causes of rhabdomyolysis include trauma, hypoxia, drugs, toxins, infections and hyperthermia. Operative insults, including direct trauma and ischemia, have the potential to cause the development of rhabdomyolysis. Pneumatic tourniquets used during arthroscopic knee surgery to prevent blood loss have led to many complications such as nerve paralysis and vascular injuries. Rhabdomyolysis can also be caused by prolonged pneumatic tourniquet application without a midapplication release, and also from an increased application pressure, but the actual incidence of this is low. In order to prevent rhabdomyolysis, the clinicians must be aware of such risks and follow strict guidelines for the application time, the midapplication release and also the inflation pressure. Vigorous hydration and postoperative patient surveillance are helpful to prevent rhabdomyolysis. We have recently experienced a case of rhabdomyolysis after the arthroscopic knee surgery, and the rhabdomyolysis could have been associated with the use of a pneumatic tourniquet.

Keyword

Rhabdomyolysis; Tourniquets; Kidney failure, acute

MeSH Terms

Adult
Anterior Cruciate Ligament/injuries/surgery
*Arthroscopy/statistics & numerical data
Humans
Kidney Failure/etiology/radionuclide imaging/ultrasonography
Knee Joint/*surgery
Male
Postoperative Complications/etiology/radionuclide imaging/ultrasonography
Rhabdomyolysis/*etiology/radionuclide imaging/ultrasonography
Tourniquets/*adverse effects