Saudi journal of anaesthesia · 2025
The effects of tourniquet deflation on optic nerve sheath diameter in lower limb orthopaedic surgeries.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Nagappa Saraswathi, Ravindran Riya, Krishnamurthy Yathish Sarthavalli, Chandrashekar Chandrakala
Аннотация
BACKGROUND: Pneumatic tourniquets are used in orthopedic surgeries to provide a bloodless surgical area and reduce blood loss. Tourniquet inflation causes metabolic changes, leading to cerebral vasodilatation and increased intracranial pressure (ICP). A new noninvasive method to measure optic nerve sheath diameter (ONSD) via ultrasonography to detect the raised ICP is reliable, inexpensive, and can be repeated many times.
MATERIALS AND METHODS: In this prospective observational study, 23 patients aged between 16 and 60 years, undergoing elective lower limb orthopedic surgeries under spinal anesthesia were included. After pre-anesthetic evaluation and obtaining informed written consent, an ocular ultrasound was performed to measure baseline ONSD in both eyes. Spinal anesthesia was administered and A pneumatic thigh tourniquet was applied as close as possible to the limb root and inflated to 150 mmHg-250 mmHg above the systolic blood pressure. A total of 5 measurements of ONSD were taken by the investigator (anesthetist): before giving spinal anesthesia, after giving spinal anesthesia, before tourniquet deflation, within 5 min, and after 10 min of tourniquet deflation.
RESULTS: In our study, the mean age of subjects was 34.57 ± 13.5 years. The majority were males (83%). The subjects showed an increase in ONSD after pneumatic tourniquet deflation in comparison with the baseline values, in the left eye [0.543 cm ± 0.021, P < 0.001] and the right eye [0.549 cm ± 0.021, P < 0.001], which were statistically significant.
CONCLUSION: The impact of pneumatic tourniquet deflation on ONSD measurements recorded by ultrasound in lower limb orthopedic surgeries was significant and this change occurred with a simultaneous increase in end-tidal carbon dioxide (EtCO2).
MATERIALS AND METHODS: In this prospective observational study, 23 patients aged between 16 and 60 years, undergoing elective lower limb orthopedic surgeries under spinal anesthesia were included. After pre-anesthetic evaluation and obtaining informed written consent, an ocular ultrasound was performed to measure baseline ONSD in both eyes. Spinal anesthesia was administered and A pneumatic thigh tourniquet was applied as close as possible to the limb root and inflated to 150 mmHg-250 mmHg above the systolic blood pressure. A total of 5 measurements of ONSD were taken by the investigator (anesthetist): before giving spinal anesthesia, after giving spinal anesthesia, before tourniquet deflation, within 5 min, and after 10 min of tourniquet deflation.
RESULTS: In our study, the mean age of subjects was 34.57 ± 13.5 years. The majority were males (83%). The subjects showed an increase in ONSD after pneumatic tourniquet deflation in comparison with the baseline values, in the left eye [0.543 cm ± 0.021, P < 0.001] and the right eye [0.549 cm ± 0.021, P < 0.001], which were statistically significant.
CONCLUSION: The impact of pneumatic tourniquet deflation on ONSD measurements recorded by ultrasound in lower limb orthopedic surgeries was significant and this change occurred with a simultaneous increase in end-tidal carbon dioxide (EtCO2).