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The effect of tourniquet deflation on hemodynamics and regional cerebral oxygen saturation in aged patients undergoing total knee replacement surgery

Title
The effect of tourniquet deflation on hemodynamics and regional cerebral oxygen saturation in aged patients undergoing total knee replacement surgery
Authors
Song I.Kim D.Y.Kim Y.J.
Ewha Authors
김동연김윤진
SCOPUS Author ID
김동연scopus; 김윤진scopus
Issue Date
2012
Journal Title
Korean Journal of Anesthesiology
ISSN
2005-6419JCR Link
Citation
vol. 63, no. 5, pp. 425 - 430
Indexed
SCOPUS; KCI scopus
Abstract
Background: Inflation 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. Methods: Twenty-eight American Society of Anesthesiologists physical status I or II patients, over the age of sixtyfive 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. Results: The 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. Conclusions: In 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. © the Korean Society of Anesthesiologists, 2012.
DOI
10.4097/kjae.2012.63.5.425
Appears in Collections:
의학전문대학원 > 의학과 > Journal papers
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