Minimal Inflation Tourniquet Pressure Using Induced Hypotension With Limb Occlusion Pressure Determination or Arterial Occlusion Pressure Estimation in Upper Limb Surgery: A Randomized Double Blinded Comparative Study
试验速览
- 阶段
- 不适用
- 入组人数
- 20
- 试验地点
- 1
- 主要终点
- Tourniquet inflation pressure
研究概览
简要总结
Limb occlusion pressure (LOP) and arterial occlusion pressure (AOP) are the terms that mean the lowest tourniquet pressure required to stop the arterial blood flow into the limb distal to the cuff. LOP can be determined manually or automatically by slow cuff inflation until disapper of pulsation with Doppler flow-meter or pulse oximeter
详细描述
The advantages of the tourniquet during upper or lower limb procedures are providing bloodless operative field and so less intra-operative blood lossIt has been reported that using the lowest effective inflation pressure minimize tourniquet induced nerve injury .). Limb occlusion pressure (LOP) and arterial occlusion pressure (AOP) are the terms that mean the lowest tourniquet pressure required to stop the arterial blood flow into the limb distal to the cuff. LOP can be determined manually or automatically by slow cuff inflation until disapper of pulsation with Doppler flowmeter or pulse oximeter .AOP can be estimated by a formula (AOP = [SBP + 10]/KTP) using patient's systolic blood pressure (SBP) and tissue padding coefficient (KTP) values. In both methods, addition of a safety margin to LOP or AOP is recommended for potential hemodynamic fluctuations during surgery
研究设计
- 研究类型
- Observational
- 观察模型
- Case Control
- 时间视角
- Prospective
入排标准
- 年龄范围
- 20 Years 至 50 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •• ASA physical status I and II.
- •Male and female patient
- •Age group 20-50 years old
排除标准
- •• Patient who refuse to participate in the study
- •Patients with contraindication of using the tourniquet (e.g. peripheral vascular disease or coronary artery disease sickle cell anemia neuromuscular disorders,)
- •Contraindications of using induced hypotensive anesthesia (cerebrovascular disease, Impaired kidney function , chronic liver disease, pregnancy).
- •Patients on medications influencing blood flow such as nitrogycerine
- •Surgery extends more than 90 minutes.
- •Hypertensive patients
结局指标
主要结局
Tourniquet inflation pressure
时间窗: tourniquet inflation pressures will be recorded at 0, 5, 15, 30, 60, and 120 min.
the tourniquet inflation pressure will be determined based on the Arterial occlusion pressure or the limb occlusion pressure
time required to set the tourniquet inflation pressures
时间窗: one minute before inflation of the tourniquet cuff
Time needed to estimate AOP or to determine LOP and set the tourniquet cuff pressure.
次要结局
- tourniquet performance(at the middle and end of surgery)
研究者
Samaa Rashwan
Assistant professor
Beni-Suef University