Tourniquet
Conditions
Brief summary
Deflation of the pneumatic tourniquet used in lower limb surgery is usually associated with hemodynamic instability, metabolic and respiratory changes. These changes are usually tolerated by young, healthy patients; However, these complications are risky for elderly and cardiac patients. The aim of this study is to assess the effect of gradual deflation of thigh tourniquet on the hemodynamics and arterial blood gases compared to the usual practice
Detailed description
Pneumatic tourniquet will be applied on the mid- thigh with cuff pressure of 350 mm Hg. After the end of surgery, the lower limb will be elevated at 45-degree and the patients will randomized into one of the three groups: G 50 (n=30) : The tourniquet cuff pressure will be deflated gradually by 50 mm Hg every 2 minutes till complete deflation. G 100 (n=30): The tourniquet cuff pressure will be deflated gradually by 100 mm Hg every 2 minutes till complete deflation. G 0 (n=30): The tourniquet cuff will be released till complete deflation. If hypotension is observed during the procedure, it will be managed by 10 mg ephedrine.
Interventions
gradual deflation with variable degrees
Sponsors
Cairo University
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
50 Years to 100 Years
Healthy volunteers
No
Inclusion criteria
* scheduled for elective orthopedic lower limb surgery under pneumatic tourniquet
Exclusion criteria
* BMI ≥35Kg/ m2 * patients with unstable angina, left ventricular dysfunction , cerebrovascular disease ,bleeding disorders * contraindication to tourniquet insertion * patients requiring massive intraoperative blood transfusion (Blood loss more than 50% of the patients' blood volume (70 ml/Kg) ).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| mean arterial blood pressure | 15 minutes after start of deflation of cuff | The lowest mean arterial blood pressure during a 15-minute period after starting deflation of the tourniquet. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| hypotension | 15 minutes after start of deflation of cuff | incidence of post tourniquet hypotension |
| cardiac output | 15 minutes after start of deflation of cuff | cardiac output after starting deflation using non invasive electrical cardiometry |
Countries
Egypt
Contacts
Primary Contactyasmin ibrahim
Outcome results
None listed