Korean J Anesthesiol.  2000 Oct;39(4):462-468. 10.4097/kjae.2000.39.4.462.

Tourniquet Induced Hypertension and Vital Sign Changes in Patients with Total Knee Replacement Arthroplasty under General Anesthesia with Enflurane or Propofol

• Chung WS
• Kim RB
• Park SS
• Yang HS
• Suh BT

• KMID: 2031603
• DOI: http://doi.org/10.4097/kjae.2000.39.4.462

Abstract

BACKGROUND: The tourniquet is associated with severe hemodynamic changes and tourniquet-induced hypertension (T-HTN). Propofol is preferred as an anesthetic agent for rapid induction and recovery, and less nausea and vomiting. The aim of this study was to find the difference in hemodynamic changes and the T-HTN in patients with total knee replacement arthroplasty receiving enflurane or propofol anesthesia.
METHODS
One hundred patients underwent total knee replacement arthroplasty were divided into four groups; enflurane-control (n = 22), enflurane-elderly (n = 28), propofol-control (n = 22), propofol-elderly (n = 28). Mean arterial blood pressure (MAP), heart rate (HR) and end-tidal CO2 (PETCO2) were recorded throughout the operations of each group. Statistical analysis was done using repeated measures of ANOVA, chi-square test (P < 0.05).
RESULTS
MAP increased in the propofol group during the tourniquet inflation period compared to the period before tourniquet inflation. The incidence of T-HTN in the propofol group (58%) was higher than that of the enflurane group (36%). HR increased in the enflurane group just after tourniquet inflation. PETCO2 decreased during 20 60 minutes after tourniquet inflation in the propofol group (P < 0.05). MAP decreased and PETCO2 increased during the 1, 5 minutes after tourniquet deflation in all groups. There were minimal HR changes after tourniquet deflation in all groups.
CONCLUSIONS
T-HTN occurrence and MAP were shown to be higher in the propofol anesthesia and both enflurane and propofol can be used as an anesthetic agent for total knee replacement arthroplasty without complications.

Keyword

Anesthetics, intravenous: enflurane; propofol; volatile; Blood pressure: tourniquet induced hypertension; Equipment: tourniquet

MeSH Terms

Anesthesia
Anesthesia, General*
Arterial Pressure
Arthroplasty*
Arthroplasty, Replacement, Knee*
Enflurane*
Heart Rate
Hemodynamics
Humans
Hypertension*
Incidence
Inflation, Economic
Nausea
Propofol*
Tourniquets*
Vital Signs*
Vomiting
Enflurane
Propofol