Metabolic Changes in the Upper Limb During Tourniquet Ischaemia:<i>A Clinical Study</i>

Solonen, Kauko A.; Tarkkanen, L.; Närvänen, S.; Gordin, Ruben

doi:10.3109/17453676808989436

Cited by 37 publications

(10 citation statements)

References 3 publications

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“…Caldwell previously showed in isolated muscle preparations that sonic muscle tissue fatigue sets in at pH 7.0 and rigor follows at pH 6.0 . The Wilgis results complement a similar study by Solonen and colleagues in Finland in which they histologically depicted capillary and cell damage in striated muscle caused by ischemia up to 2 hours. They demonstrated that the pH decreased enough to indicate that ischemia of longer than 2 hours using a tourniquet may be approaching these critical points.…”

Section: Discussionsupporting

confidence: 82%

“…Accordingly, measurements have been made on venous blood withdrawn during and after the use of pneumatic tourniquets. 5,7,8,29,30 These investigations were based on the premise that chemical .001, BTA vs 10 minutes 20 minutes 7.08 AE 80.09 (6.89-7.31) .001, 10 minutes vs 20 minutes 30 minutes 6.91 AE 0.12 (6.63-7.25) .001, 20 minutes vs 30 minutes 40 minutes 6.76 AE 0.12 (6.50-6.99)…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effects of Digital Tourniquet Ischemia: A Single Center Study

Becerro-de-Bengoa-Vallejo

Iglesias

López‐López

et al. 2013

Dermatologic Surgery

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Tourniquet application time is precious. While operating under tourniquet control, the extremity becomes increasingly acidotic. Tourniquet ischemia longer than 20 minutes causes local acidosis and muscle fatigue. Women and persons who weighed less could reach acidotic pH values faster than men or heavier patients. If applications longer than 20 minute are expected, the tourniquet should be released at 20 minutes, allowing the finger to reperfuse for 3-5 minutes to clear the acidosis before reapplication of tourniquet.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Effects of Digital Tourniquet Ischemia: A Single Center Study

Becerro-de-Bengoa-Vallejo

Iglesias

López‐López

et al. 2013

Dermatologic Surgery

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show abstract

“…Marked hypertensive responses ( > 30%) in the present study were seen only in the general anaesthesia patients (8/15). The balanced anaesthesia including enflurane inhalation at or above 1 MAC concentration (7) was unable to prevent a hypertensive response in the majority of patients. In a retrospective analysis of 724 patients with a tourniquet and undergoing orthopaedic surgery under different types of anaesthesia, approximately 64% of the balanced anaesthesia patients had an increase in arterial blood pressure exceed-ing 30% anaesthesia, in contrast to approximately 2% during spinal anaesthesia (unpublished observation).…”

Section: Haemodynamic Changesmentioning

confidence: 92%

Effects of Three Anaesthesia Methods on Haemodynamic Responses Connected with the Use of Thigh Tourniquet in Orthopaedic Patients

Valli

Rosenberg

1985

Acta Anaesthesiol Scand

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Haemodynamic changes were studied in 51 patients undergoing orthopaedic surgery of the lower extremity, including exsanguination and thigh tourniquet for longer than 60 min. The patients were randomly divided into three anaesthesia groups: general anaesthesia (including enflurane), epidural anaesthesia (20 ml 0.5% bupivacaine) and spinal anaesthesia (3 ml 0.5% bupivacaine). During the study, five epidural and one spinal patient excluded from haemodynamic comparison required general anaesthesia because of pain from the surgery or ischaemia. In the general anaesthesia group, there was a rise in either systolic or diastolic arterial pressure of over 30% of the control value in 8/15 patients. In the spinal anaesthesia patients, there was a transient rise above 30% in only one patient out of 15 and no rise in the 15 epidural group patients. On the other hand, 11/15 of the epidural patients needed additional analgesics and/or sedation for pain or restlessness. The mean rise in the haemodynamic parameters including CVP was small on inflation of the tourniquet cuff; on deflation there was a mean decrease in CVP of 1-3 cmH2 (0.1-0.3 kPa), the maximum decrease being 8 cmH2O (0.8 kPa). The mean decrease in systolic arterial blood pressure ranged from 2 to 14 mmHg (0.27 to 1.87 kPa) when the cuff was deflated.

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“…The acute interruption of blood flow causes metabolic disorders which could be of importance in the pathogenesis of tourniquet injuries. The ef fects of tourniquet ischemia on acid-base balance in the arm [2,18], and short-term [5] and 2-hour [7] ischemia in the leg have been investigated in man. Studies on animals have been carried out by several authors [2,5], Metabolic disturbances have also been investigated during reconstruc tive arterial surgery [6,8,14,17].…”

Section: /L Ew Is/l üJedahl/lôfstrômmentioning

confidence: 99%

Early Biochemical and Hemodynamic Changes after Operation in a Bloodless Field

Larsson¹,

Lewis²,

Liljedahl³

et al. 1977

Eur Surg Res

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Biochemical and hemodynamic changes during and after operation in a bloodless field have been investigated in 13 patients. The patients were athletes between the ages of 21 and 38 years who were healthy except for an inveterate ligament injury of the knee joint. Capillary blood flow in the tibialis anterior muscle was measured by the radioactive-Xenon-clearance technique. Fine plastic catheters for blood sampling were inserted into both femoral veins and into one radial artery. A significant increase in blood flow occurred immediately after release of the occlusion. After release of the tourniquet, there was a marked decrease in pH both in the venous blood draining the operated leg and in the arterial blood. 40 min after release of the tourniquet, there was still a significant decrease in base excess. An increase of venous pO₂ in the blood draining the operated leg was observed after re-establishment of blood flow. The estimated oxygen consumption was increased in the operated leg the first 10 min after tourniquet release.

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Metabolic Changes in the Upper Limb During Tourniquet Ischaemia:A Clinical Study

Abstract: View related articles Citing articles: 28 View citing articles I'ro1n the Cliiiir for 0rtllop:irtlics and l'raiimattrlogg, llrncl : Profcssor I<. 15. I(allio, and the Chilclrrii's Clinic, Hrad : IBrofrssor Niilo Hallmaii, of tlic lliiivrrsity Crntral Hospital, Hclsiiilti.

Cited by 37 publications

References 3 publications

Effects of Digital Tourniquet Ischemia: A Single Center Study

Effects of Digital Tourniquet Ischemia: A Single Center Study

Effects of Three Anaesthesia Methods on Haemodynamic Responses Connected with the Use of Thigh Tourniquet in Orthopaedic Patients

Early Biochemical and Hemodynamic Changes after Operation in a Bloodless Field

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