JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (3) Citing Articles via Google Scholar Google Scholar Articles by Hirota, K. Articles by Matsuki, A. Search for Related Content PubMed PubMed Citation Articles by Hirota, K. Articles by Matsuki, A. Related Collections Cardiovascular Surgery Heart Postanesthetic Care Unit

---

GENERAL ARTICLES

Quantification and Comparison of Pulmonary Emboli Formation After Pneumatic Tourniquet Release in Patients Undergoing Reconstruction of Anterior Cruciate Ligament and Total Knee Arthroplasty

Department of Anesthesiology, University of Hirosaki School of Medicine, Japan

Address correspondence and reprint requests to Kazuyoshi Hirota, MD, Department of Anesthesiology, University of Hirosaki School of Medicine, Hirosaki 036-8562, Japan. Address e-mail to masuika{at}cc.hirosaki-u.ac.jp

The amount of emboli formed (percentage of total emboli area to the right atrial area [%Ae]) after tourniquet release in invasive procedures of the medullary cavity is empirically much larger than that in noninvasive procedures, even if the tourniquet duration is similar. Thus, we compared %Ae between arthroscopic reconstruction of the anterior cruciate ligament (ACL, n = 20) and total knee arthroplasty (TKA, n = 20). The right atrium was continuously monitored by transesophageal echocardiography to assess %Ae. Peak %Ae ± SD (ACL, 4.1% ± 3.4%; TKA, 20.7% ± 16.7%) appeared 30–40 s after tourniquet release in both groups. However, %Ae in the TKA group was always larger than the peak %Ae in the ACL group. In addition, although the ETCO₂ significantly increased after tourniquet release in both groups, increase of ETCO₂ (1.1% ± 0.3%) in the ACL group was significantly larger than that in the TKA group (0.5% ± 0.2%). An increase in ETCO₂ was inversely proportional to peak %Ae (P < 0.01; r = 0.703). Therefore, the present data suggest that the risk of acute pulmonary embolism after tourniquet release may be more frequent during TKA than ACL.

IMPLICATIONS: We compared emboli formation after tourniquet release in patients undergoing arthroscopic reconstruction of the anterior cruciate ligament (ACL, n = 20) and total knee arthroplasty (TKA, n = 20) using transesophageal echocardiography. The present data suggest that the risk of acute pulmonary embolism after tourniquet release could be more frequent during TKA than ACL.

This article has been cited by other articles:

				F. Mahmood, A. Christie, and R. Matyal Transesophageal Echocardiography and Noncardiac Surgery Seminars in Cardiothoracic and Vascular Anesthesia, December 1, 2008; 12(4): 265 - 289. [Abstract] [PDF]

				R. P. A. Janssen and H. A. G. M. Sala Fatal Pulmonary Embolism After Anterior Cruciate Ligament Reconstruction Am. J. Sports Med., June 1, 2007; 35(6): 1000 - 1002. [Full Text] [PDF]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999