Tourniquet failure and arterial calcification

Jeyaseelan, S.; Stevenson, Tamasin; Pfitzner, J.

doi:10.1111/j.1365-2044.1981.tb08599.x

Cited by 40 publications

(15 citation statements)

References 8 publications

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“…In addition, the use of tourniquets and subsequent pressure on preexisting atheromatous plaques are associated with arterial ischemic complications after TKA [6, 13, 14]. The use of tourniquets during TKA is controversial.…”

Section: Discussionmentioning

confidence: 99%

Asymptomatic peripheral vascular disease in total knee arthroplasty: preoperative prevalence and risk factors

Park

Lee

Park

et al. 2014

J Orthopaed Traumatol

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BackgroundAlthough vascular disease is commonly accepted as a risk factor for wound complications and prosthetic joint infections, little is known about the preoperative prevalence of lower-extremity peripheral vascular disease in patients undergoing total knee arthroplasty (TKA). In this study, we investigated the prevalence of asymptomatic vascular disease and its risk factors.Materials and methodsA total of 1,000 knees of 692 patients who underwent primary TKA due to osteoarthritis were preoperatively evaluated by experienced musculoskeletal radiologists using Doppler ultrasonography of the lower extremity vessels. The mean age of the patients was 74.1 years (range 65–81). Risk factors for development of peripheral vascular disease were investigated.ResultsAbnormal findings were identified in 38 knees of 32 patients (4.6 %); atherosclerotic changes in 31 knees of 25 patients (3.6 %), deep vein thrombosis (DVT) in two knees, and anomalous vessels in five knees. Three out of 31 knees with atherosclerotic changes showed severe luminal stenosis. Two knees were moderate and 26 knees showed mild changes according to our institutional criteria. Multivariate logistic regression analysis showed that age and diabetes mellitus were positively associated with vascular pathology.ConclusionThe prevalence of incidentally detected peripheral vascular disease was significant. Three of 31 knees had severe arterial stenosis and two knees had DVT. All patients with vascular pathologies had one or more risk factors related to vascular disease. Out of those patients, age was the most important risk factor. Understanding the prevalence of vascular pathology and related risk factors in TKA candidates may be important for successful TKA.Level of Evidence Level III.

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Section: Discussionmentioning

confidence: 99%

Asymptomatic peripheral vascular disease in total knee arthroplasty: preoperative prevalence and risk factors

Park

Lee

Park

et al. 2014

J Orthopaed Traumatol

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show abstract

“…Tourniquets are widely used in operating rooms under controlled conditions and have been studied for safety, effectiveness, and related complications under those conditions. [87][88][89][90][91][92][93][94] Arterial tourniquets, however, cause injury as a result of ischemia after 90 minutes of compression. Complications include bleeding, injury to soft tissues, nerve and vascular injury, and paralysis.…”

Section: Hemorrhagementioning

confidence: 99%

Part 5: New Guidelines for First Aid

2000

Circulation

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“…The tourniquet should be regularly maintained, old tubing replaced, connections checked for security and the pressure gauge calibrated. The technique may fail in the obese or the hypertensive patient (Ogden, 1984), through failure to achieve arterial occlusion because of arterial calcification (Jeyasseelan, Stevenson and Pfitzner, 1981) or in the presence of a vigorous osseous circulation (Cotev and Robin, 1966) such as might occur in Paget's disease of the bone. Finally, many surgeons find that the exsanguination achieved by this technique is not adequate for fine work on the hand and prefer brachial plexus blockade if regional anaesthesia is indicated.…”

Section: Intravenous Blocksmentioning

confidence: 99%

Local Anaesthesia for Orthopaedic Surgery

Mckenzie

Loach

1986

British Journal of Anaesthesia

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Regional anaesthesia has more to offer in orthopaedic surgery than in any other surgical specialty, either alone or as part of an anaesthetic sequence. The advantages of regional anaesthesia may include better postoperative recovery and analgesia, reduction in intraoperative blood loss and better preservation of mental function in the elderly. In this review, aspects of regional anaesthesia for orthopaedic procedures are discussed, first for central neural blockade and then for peripheral nerve blocks. CENTRAL NEURAL BLOCKADE: EXTRADURAL AND SUBARACHNOID BLOCK Central Neural Blockade is used mainly for surgery involving the lower limb. In this area, there is controversy on the role of regional anaesthesia in contemporary practice. The majority of evidence comparing the effects of regional anaesthesia with general anaesthesia exists for patients undergoing hip surgery. This includes elective total hip replacement and surgery for fractured neck of femur, including primary hip prosthesis or internal fixation. In this section, regional anaesthesia is compared with conventional general anaesthesia for elective and emergency hip surgery as judged by their effects on various important aspects of morbidity and mortality.

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Tourniquet failure and arterial calcification

Abstract: Summary

Cited by 40 publications

References 8 publications

Asymptomatic peripheral vascular disease in total knee arthroplasty: preoperative prevalence and risk factors

Asymptomatic peripheral vascular disease in total knee arthroplasty: preoperative prevalence and risk factors

Part 5: New Guidelines for First Aid

Local Anaesthesia for Orthopaedic Surgery

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