Key result
Dexmedetomidine plus isoflurane is linked to preventing BP and pulse rate increases vs isoflurane alone.
Why the study?
Pneumatic tourniquets can cause hyperdynamic cardiovascular responses during surgery that are not corrected by analgesia, anti-hypertension, or increased anesthesia depth, potentially leading to complications.
Does a combination of dexmedetomidine and isoflurane prevent tourniquet-induced increases in blood pressure, mean arterial pressure, and pulse rate in patients undergoing lower extremity surgery?
Cohort
Does a combination of dexmedetomidine and isoflurane prevent tourniquet-induced increases in blood pressure, mean arterial pressure, and pulse rate in patients undergoing lower extremity surgery?
The combination of dexmedetomidine and isoflurane for anesthesia maintenance effectively blunts the hyperdynamic cardiovascular responses caused by tourniquet inflation during lower extremity surgery.
Dexmedetomidine-isoflurane may blunt tourniquet hemodynamic responses in lower-limb surgery; leaves open whether this extends to outcomes or other populations.
Introduction: The utilization of pneumatic tourniquets in surgery can help surgeons optimize the surgical field and reduce the amount of bleeding. It can also cause hyperdynamic cardiovascular responses, such as increased blood pressure, mean arterial pressure, and pulse rate, which the administration of analgesia, anti-hypertension, and increased depth of anesthesia cannot correct. Excessive hemodynamic responses can lead to complications due to the utilization of tourniquets, namely increased intracranial pressure and acute heart failure. This study aims to analyze differences in the effects of tourniquet inflation on blood pressure, mean arterial pressure, and pulse rate during the maintenance of anesthesia using a combination of dexmedetomidine and isoflurane compared to that using only isoflurane for patients undergoing lower extremity surgery. Methods: This observational cohort study. The statistical test in this study was conducted using the Shapiro-Wilk test for normality and the Spearman test for correlation. The Chi-Square test was carried out to ensure the characteristics of patients in the two groups. Results: The results showed no significant effects of tourniquet inflation on blood pressure, mean arterial pressure, and pulse rate during the maintenance of anesthesia using a combination of dexmedetomidine and isoflurane. Meanwhile, tourniquet inflation during the maintenance of anesthesia using only isoflurane resulted in significant effects on blood pressure, mean arterial pressure, and pulse rate. The results also indicated significant differences between the effects of tourniquet inflation during the maintenance of anesthesia using a combination of dexmedetomidine and isoflurane and that using only isoflurane on the blood pressure, mean arterial pressure and pulse rate of patients undergoing lower extremity surgery. Conclusion: There are no significant effects of tourniquet inflation during the maintenance of anesthesia using a combination of dexmedetomidine and isoflurane on the blood pressure, mean arterial pressure, and pulse rate of patients undergoing lower extremity surgery.
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Wijanarko et al. (2023) conducted a cohort in Lower extremity surgery. Combination of dexmedetomidine and isoflurane vs. Isoflurane only was evaluated on Changes in blood pressure, mean arterial pressure, and pulse rate during tourniquet inflation. A combination of dexmedetomidine and isoflurane prevented significant increases in blood pressure and pulse rate during tourniquet inflation compared to isoflurane alone in lower extremity surgery.
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