Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
Hypotensive epidural anesthesia in total knee replacement without tourniquet: Reduced blood loss and transfusion
Autore:
Juelsgaard, P; Larsen, UT; Sorensen, JV; Madsen, F; Soballe, K;
Indirizzi:
Aarhus Univ Hosp, Aarhus Kommune Hosp, Dept Anesthesiol, Aarhus, Denmark Aarhus Univ Hosp Aarhus Denmark Hosp, Dept Anesthesiol, Aarhus, Denmark Aarhus Univ Hosp, Aarhus Kommune Hosp, Dept Orthoped Surg, Aarhus, DenmarkAarhus Univ Hosp Aarhus Denmark sp, Dept Orthoped Surg, Aarhus, Denmark
Titolo Testata:
REGIONAL ANESTHESIA AND PAIN MEDICINE
fascicolo: 2, volume: 26, anno: 2001,
pagine: 105 - 110
SICI:
1098-7339(200103/04)26:2<105:HEAITK>2.0.ZU;2-Q
Fonte:
ISI
Lingua:
ENG
Soggetto:
TOTAL HIP-ARTHROPLASTY; THROMBOSIS;
Keywords:
blood loss; hypotensive epidural anesthesia; total knee replacement; tourniquet; transfusion;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
22
Recensione:
Indirizzi per estratti:
Indirizzo: Juelsgaard, P Tokkerbakken 20, DK-8240 Risskov, Denmark Tokkerbakken 20 Risskov Denmark DK-8240 0 Risskov, Denmark
Citazione:
P. Juelsgaard et al., "Hypotensive epidural anesthesia in total knee replacement without tourniquet: Reduced blood loss and transfusion", REG ANES PA, 26(2), 2001, pp. 105-110

Abstract

Background and Objectives: For decades, hypotensive anesthesia has been used in an attempt to reduce intraoperative blood loss. Hypotensive epidural anesthesia (HEA) is a relatively new technique in hypotensive anesthesia. Use of a tourniquet has been shown to be associated with a higher risk of cardiovascular and thromboembolic complications. The effect of HEA on blood loss and need for transfusion in total knee replacement (TKR) is not known. Methods: Thirty consecutive patients scheduled for TKR were randomized to HEA. without tourniquet or spinal anesthesia with the use of a tourniquet (SPI). HEA was performed as an epidurally induced sympathetic block and there was an infusion of low-dose epinephrine to stabilize the circulation. Results: Intraoperative mean arterial blood pressure was 48 mm Hg (HEA) versus 83 mm Hg (SPI) (P < .001). Intraoperative blood loss was 146 mt (HEA) versus 13 mt (SPI) (P < .001). Postoperative blood loss at any time was significantly reduced in the HEA group, and total loss of blood was 1,056 mt (HEA) versus 1,826 mL (SPI) (P < .001). Half of the bleeding took place during the first 3 postoperative hours and 80% during the first 24 hours. In the HEA group, 57% of the patients went through surgery and the hospital staywithout receiving blood transfusion versus 19% in the SPI group (P < .05). There was a significantly reduced amount of blood transfusion in the HEA group (193 mt) versus 775 mt in the SPI group (P < .005). No cardiopulmonary, cerebral, or renal complications were registered. Conclusions: We conclude that HEA is a safe technique that allows TKR without a tourniquet. Compared with spinal anesthesia, the use of HEA for TKR significantly reduces blood loss and the need for blood transfusion.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 03/04/20 alle ore 10:21:52