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Category: Volume 07 Issue 08 August 2019
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Title: End tidal carbon dioxide (EtCO2) and hemodyanamic changes following tourniquet release in lower limb surgery under general anesthesia

Authors: Diptimayee Mallik, Bhavna Sriramka, Sudeep Mohapatra, Megha Khetan

 DOI: https://dx.doi.org/10.18535/jmscr/v7i8.16

Abstract

Utilization of pneumatic tourniquet is a normal practice in most appendage medical procedures for orthopedic, plastic/reconstructive surgery to acquire a bloodless field. this study to analyze the end tidal CO2 and hemodynamic changes following tourniquet release in lower limb surgeries under General anaesthesia. A total of  150 patients of ASA physical status Class I and II, of either sex in the age group of 18 to 55 years who underwent  elective surgery on the lower limbs using pneumatic tourniquet , under General anaesthesia were considered, Data collected 4 times during General anaesthesia, 15 minutes after  induction of anaesthesia, 30 minutes after inflation  of tourniquet, 5minutes after deflation and 15 minutes after deflation of tourniquet. Heart rate during the period of tourniquet inflation it is remains same or slightly increased to a mean of 103.05 ± 15.50 beats/min. But after the tourniquet deflation the heart rate showed a progressive rise. The peak increase was seen immediately after the tourniquet release (after 5 minutes) by 123±16.04 beats/min. During 30 minutes after tourniquet the MAP remains same or may increase slightly to 95.489±2.44 mm Hg which is statistically significant. Then 5 minutes after tourniquet deflation there is sudden and gross decrease in MAP to 85.37±4.88 mmHg. the EtCO2 30 minutes after tourniquet inflation was more or less equal that is 31.316±1.38 mmHg. Then at tourniquet deflation after 5 minutes there is rise of EtCO2 to 41.317±1.913mmHg then it gradually comes to baseline.  Heart rate, ETCO2 , and mean arterial pressure showed minimal change during inflation phase while there occurs significant change after deflation.

Keywords: Tourniquet, EtCO2 , Hemodyanamic, Tourniquet inflation.

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Corresponding Author

Megha Khetan

Department of Anaesthesiology and Critical Care, IMS and SUM hospital, Siksha “O” Anusandhan University (Deemed to be), K8, Kalinga nagar, Bhubaneswar-751003, Odisha, India