Volume : 7, Issue : 4, April - 2018

PREOPERATIVE DEXMEDETOMIDINE PREVENTS TOURNIQUET INDUCED HYPERTENSION IN UPPER LIMB ORTHOPAEDIC SURGERIES DURING GENERAL ANAESTHESIA

Dr. Kamal Raj Singh, Dr. Jitendra Agrawal, Dr Bhanu Choudhary

Abstract :

<p class="MsoNormal" style="text-align:justify;text-justify:inter-ideograph;&#10;mso-layout-grid-align:none;text-autospace:none"><b><span style="font-size:12.0pt;&#10;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Introduction: </span></b><span style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">During limb operations tourniquets are widely used to minimize surgical bleeding and to maintain a relatively bloodless field. Tourniquet induced hypertension occurs more frequently under general anaesthesia than spinal anaesthesia and more with lower limb tourniquet than with upper limb tourniquet and can be serious in patients with cardiopulmonary diseases, neurological disease and glaucoma. This study was designed to investigate the hemodynamic effects of dexmedetomidine on prolonged tourniquet inflation. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align:justify;text-justify:inter-ideograph;&#10;mso-layout-grid-align:none;text-autospace:none"><b><span style="font-size:12.0pt;&#10;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Material and Methods: </span></b><span style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Sixty patients scheduled for elective orthopaedic surgery of the upper limb under general anaesthesia were recruited. They were randomly assigned to receive intravenous dexmedetomidine (0.5 mcg/kg; n=30) or normal saline (NS group; n = 30) before tourniquet inflation. Arterial blood pressure and heart rate were recorded every 10 minutes until 90 minutes after the start of tourniquet inflation and again immediately after deflation. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align:justify;text-justify:inter-ideograph;&#10;mso-layout-grid-align:none;text-autospace:none"><b><span style="font-size:12.0pt;&#10;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Result: </span></b><span style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">In the dexmedetomidine group, arterial pressure was not significantly changed, but in the Control group arterial pressure was significantly increased at 90 minutes after the start of tourniquet inflation. Development of more than 30% increase in arterial pressure during tourniquet inflation was more frequent in the Control group than in the dexmedetomidine group. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align:justify;text-justify:inter-ideograph;&#10;mso-layout-grid-align:none;text-autospace:none"><b><span style="font-size:12.0pt;&#10;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Conclusion: </span></b><span style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Preoperative intravenous dexmedetomidine could therefore prevent tourniquet-induced hypertension in patients undergoing general anaesthesia. <o:p></o:p></span></p>