BLOOD AND CENTRAL VENOUS-PRESSURE RESPONSES AFTER SERIAL TOURNIQUET DEFLATION DURING BILATERAL TOTAL KNEE REPLACEMENT

Thirty-five patients who underwent one-stage bilateral total knee repl acement were included in this study to determine whether there was all y difference in hemodynamic effects following the deflation of the fir st and second tourniquets. The values of hemodynamic variables were no t significantly different immediately before either the first or the s econd tourniquet release as compared to preoperative values. The chang es in heart rate after the release of the first and second tourniquets showed similar patterns. The systolic and diastolic blood pressure de creased significantly after deflation of the first and second tourniqu ets. However, the decrease was more marked after the second tourniquet deflation. The level of central venous pressure decreased significant ly after the release of the first and second tourniquets but the patte rns of change were not significantly different. The need for administr ation of ephedrine was also higher after the deflation of the second t ourniquet than after the first. We conclude that the blood pressure ch anges after the second tourniquet deflation are more pronounced than t hose following the first tourniquet deflation. Anesthesiologists must be art are of this phenomenon and prevent marked hemodynamic changes t hat could be detrimental to high-risk patients.