Linked Life Data

16492857

Source:http://linkedlifedata.com/resource/pubmed/id/16492857

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
3
pubmed:dateCreated
2006-2-22
pubmed:abstractText
Nerve injury after prolonged tourniquet inflation results from the combined effects of ischemia and mechanical trauma. Tourniquet release, allowing a reperfusion interval of 10-30 min followed by re-inflation, has been recommended to extend the duration of total tourniquet time. However, this practice has not been confirmed clinically. We retrospectively reviewed the medical records of 1001 patients undergoing 1166 primary or revision knee replacements with tourniquet time more than 120 min during a 5-yr interval. Mean total tourniquet time was 145 +/- 25 min (range, 120-308 min). In 759 patients, the tourniquet inflation was uninterrupted. Two tourniquet inflations, interrupted by a single deflation, were noted in 371 patients, and 3 tourniquet inflations interrupted by 2 deflation intervals were noted in 23 patients. A total of 129 neurologic complications (peroneal and/or tibial nerve palsies) were noted in 90 patients for an overall incidence of 7.7%. Eighty-five cases involved the peroneal nerve and 44 cases involved the tibial nerve. In 39 cases, both peroneal and tibial deficits were noted. Complete neurologic recovery occurred in 76 (89%) peroneal and 44 (100%) tibial palsies. Postoperative neurologic dysfunction was associated with younger age (P < 0.001; odds ratio = 0.7 per 10-yr increase), longer tourniquet time (P < 0.001; odds ratio = 2.8 per 30-min increase), and preoperative flexion contracture >20 degrees (P = 0.002; odds ratio = 3.9). In a subset of 116 patients with tourniquet times > or =180 min, longer duration of deflation was associated with a decreased frequency of neurologic complications (P = 0.048). We conclude that the likelihood of neurologic dysfunction increases with total tourniquet time and that a reperfusion interval only modestly decreases the risk of nerve injury.
pubmed:commentsCorrections
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:status
MEDLINE
pubmed:month
Mar
pubmed:issn
1526-7598
pubmed:author
pubmed:issnType
Electronic
pubmed:volume
102
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
950-5
pubmed:dateRevised
2006-12-7
pubmed:meshHeading
pubmed:year
2006
pubmed:articleTitle
Anesthetic, patient, and surgical risk factors for neurologic complications after prolonged total tourniquet time during total knee arthroplasty.
pubmed:affiliation
Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota 55905, USA. horlocker.terese@mayo.edu
pubmed:publicationType
Journal Article