Volume 5, Issue 4 (Journal of Anesthesiology and Pain 2015)                   JAP 2015, 5(4): 1-10 | Back to browse issues page


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mohseni M, alimian M, siamdoost A, jamshidi F. The hemodynamic and respiratory effects of Remote Ischemic Preconditioning on patients undergoing lower limb orthopaedic surgery. JAP. 2015; 5 (4) :1-10
URL: http://jap.iums.ac.ir/article-1-5198-en.html

1- ostadyar medicine
2- resident medicine , dr.jamshidi78@yahoo.com
Abstract:   (985 Views)
Aim and Background: Arterial tourniquets are used widely for extremity orthopedic surgeries with regional or
general anesthesia to reduce blood loss, but the harmful effect of ischemia and reperfusion is not clear yet.
Materials and Methods: In this clinical trial 40 patients scheduled for lower extremity surgery with pneumatic
tourniquet were randomized into 2 groups: a remote ischemic preconditioning (RIP group, n=20), in which
patients received three “5 minutes” cycles of ischemia, alternating with 5 minutes of reperfusion before extended
use of tourniquet and a control group (n=19). Hemodynamic variables prior to inflation of tourniquet and every
30 minutes during the surgery and 10 minutes after tourniquet deflation and arterial blood gas sample prior to and
after surgery were compared between groups.
Findings: In comparison with the baseline values, systemic blood pressure was increased in all patients, however
in control group it was significantly more than baseline values and also higher than the RIP group (p=0.03 and
p=0.032 respectively). There was no significant change in heart rate and O2 saturation and Spontaneous respiratory
rate between the groups and in comparison with baseline values.
Conclusion: Tourniquet application in limb surgery can cause hemodynamic changes and remote ischemic
preconditioning can not attenuate these effects such as variation of blood pressure, heart rate and changes of
respiatory rate and arterial O2 saturation. However RIP can reduce inceases in systolic blood pressure and acidosis.
Keywords: Hemodynamics, Ischemic preconditioning, Ischemia-reperfusion, Orthopedic Surgery, Tourniquet
Full-Text [PDF 360 kb]   (635 Downloads)    
Type of Study: Original | Subject: Special
Received: 2015.04.4 | Accepted: 2015.05.12 | Published: 2015.06.22

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