Relation between preoperative autonomic function and blood pressure change after tourniquet deflation during total knee replacement arthroplasty
Korean Journal of Anesthesiology, 02/24/2012
Huh IY et al. – Preoperative low baroreflex sensitivity (BRS) is associated with hypotension after tourniquet deflation, suggesting the importance of baroreflex regulation for intraoperative hemodynamic stability.
Eighty-six patients who underwent total knee replacement arthroplasty (TKRA) were studied.
HRV, systolic blood pressure variability (SBPV) and baroreflex sensitivity (BRS) were analyzed.
The authors assigned two groups depending on the lowest systolic blood pressure (SBP) or mean BP (MBP) after tourniquet release (Group H; SBP <80mmHg or MBP <60mmHg, Group S; SBP >80mmHg and MBP >60mmHg).
Fifteen patients developed severe hypotension and ten patients were treated with ephedrine.
Of the parameters of HRV, SBPV, and BRS, only BRSSEQ was significant being low in Group H.
BRS and high-frequency SBPV were correlated with the degree of MBP change after tourniquet deflation.
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