Obese patients require higher, but not high pneumatic tourniquet inflation pressures using a novel technique during total knee arthroplasty
| Autor: | Şükrü Araç, Hakan Boya, Zeynep Kayhan, Bahattin Tuncali |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
Systole medicine.medical_treatment Blood Pressure Pneumatic tourniquet Body Mass Index 03 medical and health sciences 0302 clinical medicine Pressure Humans Medicine Orthopedics and Sports Medicine Obesity Arthroplasty Replacement Knee Aged Aged 80 and over 030222 orthopedics Surgical team Tourniquet Arterial occlusion pressure 030504 nursing business.industry Rehabilitation Organ Size Middle Aged Tourniquets Arthroplasty Arterial occlusion Knee arthroplasty Blood pressure Lower Extremity Anesthesia Female Surgery Estimation method 0305 other medical science Complication business Body mass index |
| Zdroj: | Joint Diseases and Related Surgery. 29:40-45 |
| ISSN: | 1309-0313 1305-8282 |
| DOI: | 10.5606/ehc.2018.57973 |
| Popis: | Objectives: This study aims to investigate the effect of obesity on pneumatic tourniquet inflation pressures determined with a novel formula during total knee arthroplasty (TKA). Patients and methods: Data of 208 patients (19 males, 199 females; mean age 69.8 years; range, 53 to 84 years) who were performed TKA between January 2013 and December 2016 were evaluated prospectively. Patients were divided into two groups as non-obese (body mass index [BMI] 30.0 kg/m(2)) according to BMI. Tourniquet inflation pressures were set using arterial occlusion pressure (AOP) estimation method and adding 20 mmHg of safety margin to AOP value. All patients were assessed intra-and postoperatively with outcome measures such as systolic blood pressure, AOP, tourniquet pressure and its effectiveness. The quality of the surgical field and complications were assessed by the surgical team in a blinded fashion. Results: The study included 118 and 90 lower extremity operations in obese and non-obese groups, respectively. Compared to non-obese group; extremity circumference, initial and maximal systolic blood pressures, AOP values, initial and maximal tourniquet pressures were higher in obese group. The performance of the tourniquet was assessed as "excellent" and "good" at almost all stages of the surgical procedure in all patients in both groups. No complication occurred intra-or postoperatively. Conclusion: Compared to non-obese patients, higher tourniquet inflation pressure is required in obese patients during TKA due to their wider extremity circumference and higher systolic blood pressure profile. |
| Databáze: | OpenAIRE |
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