Korean J Anesthesiol.  2002 Mar;42(3):312-317. 10.4097/kjae.2002.42.3.312.

Effects of Four Anesthesia Methods and Tourniquet Durations on Tourniquet Induced Hypertension during Total Knee Arthroplasty

• Cheong MA
• Koh MS
• Yang HS

• KMID: 2031945
• DOI: http://doi.org/10.4097/kjae.2002.42.3.312

Abstract

BACKGROUND: A tourniquet is often used during limb surgery to minimize surgical bleeding and to keep the clear surgical field. However the tourniquet is associated with severe hemodynamic changes and tourniquet-induced hypertension. We investigated the incidences of tourniquet-induced hypertension by tourniquet duration and anesthetic methods.
METHODS
One hundred thirteen patients who underwent a total knee arthroplasty were assigned into four groups according to the types of anesthesia; general anesthesia (group I, n = 30), general anesthesia and intravenous adjuvants (group II, n = 30), general and epidural anesthesia (group III, n = 22), and spinal anesthesia (group IV, n = 31). Mean arterial pressure and heart rate were recorded at ward, before induction, one minute after tourniquet inflation and every 10 minutes until 60 mininutes. The extremity was exsanguinated and a tourniquet pressure of 350 mmHg (9 cm width) was applied in all groups.
RESULTS
The mean arterial pressure increased in group I and II during the tourniquet inflation period. The incidence of tourniquet-induced hypertension was higher in group I (6.7%) than other groups but there was no statistical significance among the groups. Heart rates were not changed in any groups.
CONCLUSIONS
We concluded that the shorter the tourniquet time the less the occurrence of tourniquet-induced hypertension under any type of anesthesia.

Keyword

Epidural anesthesia; inhalation anesthesia; spinal anesthesia; tourniquets-induced hypertension

MeSH Terms

Anesthesia*
Anesthesia, Epidural
Anesthesia, General
Anesthesia, Inhalation
Anesthesia, Spinal
Arterial Pressure
Arthroplasty*
Extremities
Heart Rate
Hemodynamics
Hemorrhage
Humans
Hypertension*
Incidence
Inflation, Economic
Knee*
Tourniquets*