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.

Methods

  • 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).

Results

  • 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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