Tourniquet Induced Hypertension and Vital Sign Changes in Patients with Total Knee Replacement Arthroplasty under General Anesthesia with Enflurane or Propofol

Abstract

Background: The tourniquet is associated with severe hemodynamic changes and toumiquet-induced hypertension (T-HTN). Propofol is pferred as an anesthetic agent for rapid induction and recovery, and less nausea and vomiting. The aim of this study was to find the difference in hemodynamic changes and the T-HTN in patients with total knee replacement arthroplasty receiving enflurane or propofol anesthesia. Methods: One hundred patients underwent total knee replacement arthroplasty were divided into four groups; enflurane-control (n = 22), enflurane-elderly (n = 28), propofol-control (n = 22), propofol-elderly (n = 28). Mean arterial blood pressure (MAP), heart rate (HR) and end-tidal CO₂ (PETCO₂ ) were recorded throughout the operations of each group. Statistical analysis was done using repeated measures of ANOVA, chai-square test (P < 0.05). Results: MAP increased in the propofol group during the toumiquet inflation period compared to the period before toumiquet inflation. The incidence of T-HTN in the propofol group (58%) was higher than that of the enflurane group (36%). HR increased in the enflurane group just after toumiquet inflation. PETCO₂ decreased during 20 60 minutes after tourniquet inflation in the propofol group (P < 0.05). MAP decreased and PO increased during the 1, 5 minutes after tourniquet deflation in all groups. There were minimal HR changes after tourniquet deflation in all groups. Conclusions: T-HTN occurrence and MAP were shown to be higher in the propofol anesthesia and both enflurane and propofol can be used as an anesthetic agent for total knee replacement arthroplasty without complications.