Evaluating The Cardiovascular Effects of Tourniquet Application

Merve Şeker

Status: Completed

Conditions: Orthopedic Disorder; Hemodynamic Instability

Treatments: Device: Mostcare (Vytech, Vygon, Padua, Italy)

Study type: Observational

Funder types: Other

Identifiers

NCT06158165

AcibademStudy

Details and patient eligibility

About

The goal of this prospective observational study is to investigate the impact of tourniquet application on cardiac efficiency through the cardiac cycle efficiency parameter and to explore how central regional technique alters this effect compared to general anesthesia.

We aim to answer the following main questions: 1) Does the use of a tourniquet reduce cardiac efficiency? 2) Does the impact of tourniquet use on cardiac efficiency vary with general anesthesia or central regional technique? The patients included in the study will be divided into two groups based on whether they receive general anesthesia or combined spinal epidural anesthesia.The patients' cardiac cycle efficiency and advanced hemodynamic monitoring parameters will be recorded during procedure.

Full description

After obtaining ethical committee approval (ATADEK; 2022-14/12), 43 patients undergoing elective unilateral total knee arthroplasty under tourniquet were enrolled in our prospective observational study. Patients were divided into two groups: general anesthesia (Group GA: 22 patients) or combined spinal epidural anesthesia (Group CSEA: 21 patients). Cardiac and vascular parameters were recorded using the new algorithmic application of arterial wave analysis called Pressure Recording Analytical Method (PRAM) at 9 time points: (T1) pre-anesthesia, (T2) post-anesthesia before tourniquet inflation, (T3-8) during tourniquet inflation, and (T9) after tourniquet deflation.

Enrollment: 43 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Planned for Elective Unilateral Total Knee Arthroplasty Under Tourniquet Application
• Aged 18 and over
• Either general anesthesia (GA) or combined spinal-epidural anesthesia (CSEA) will be administered

Exclusion criteria

• Patients under 18 years of age
• Patients with heart failure
• Patients with valve disease
• Patients with rhythm disorders
• Patients with a history of myocardial infarction in the last 3 months
• Patients unwilling to provide consent

Trial design

43 participants in 2 patient groups

General Anesthesia

Description:

Patients undergoing elective unilateral total knee arthroplasty with tourniquet application under the general anesthesia technique

Treatment:

Device: Mostcare (Vytech, Vygon, Padua, Italy)

Combined Spinal Epidural Anesthesia

Description:

Patients undergoing elective unilateral total knee arthroplasty with tourniquet application under the combined spinal epidural anesthesia technique

Treatment:

Device: Mostcare (Vytech, Vygon, Padua, Italy)