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- 주제어 : Pneumatic tourniquet (검색결과 6 건)
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인공 슬관절 전치환술 시 압박대의 압력에 따른 대퇴부 동통과 실혈량에 대한 영향
서재성 ( Jae Seong Seo ),민학진 ( Hak Jin Min ),윤의성 ( Ui Seoung Yoon ),김진수 ( Jin Soo Kim ),조기현 ( Ki Hyun Jo ),김용훈 ( Yong Hoon Kim ),박철희 ( Cheol Hee Baak ) 대한슬관절학회 2008 대한슬관절학회지 Vol.20 No.2
Purpose: We wanted to analyze the effects of tourniquet pressure on the postoperative thigh pain and blood loss of patients who undergo total knee arthroplasty. Materials and Methods: This prospective randomized study focused on one-hundred sixty-one unilateral total knee arthroplasties that were done with using a tourniquet. The tourniquet pressures were 300 mmHg in group I (seventy-four cases) and 100 mmHg higher than the systolic blood pressure in group II (eighty-seven cases). We analyzed the postoperative thigh pain with using a visual analog scale (VAS), and we assessed the hemoglobin levels and the hematocrits. Results: The incidence of postoperative thigh pain in group II was statistically lower than that of group I. The intensity of the postoperative thigh pain of group II was lower than that of group I at both 6 hours and 72 hours after surgery. There were no statistical differences in blood loss between the two groups. Conclusion: Using a tourniquet pressure of 100 mmHg above the systolic blood pressure during total knee arthroplasty can reduce the postoperative thigh pain. When comparing the above technique with a TKA using 300 mmHg of tourniquet pressure, there was no statistically significant difference of the postoperative blood loss.
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Bioimpedance를 이용한 공기지혈대 사용 전 후의 혈역학적 변화
안치홍,문철원,박진웅 慶北大學校 醫科大學 1997 慶北醫大誌 Vol.38 No.1
목적 : 공기 지혈대의 장시간 착용시 저혈압, 빈맥, 전신적 산혈증 등이 일어 날 수 있다고 보고되어 왔다. 저자는 bioimpedance법을 이용하여 공기 지혈대 착용 전 후의 혈역학적 변화를 관찰하고자 하였다. 대상 및 방법 : 상지나 하지에 공기 지혈대를 착용하여 정형외과 수술을 받을 ASA class Ⅰ or Ⅱ에 해당하는 환자 44명을 대상으로 하였다. 전신마취 하에 공기지혈대를 하지에 착용한 군을 LC군(n=22)이라 하고 상지에 착용한 군을 AC군(n=12)이라 하였으며 척추마취 하에 공기지혈대를 하지에 착용한 군을 LS군(n=10)이라 하였다. Bioimpedanre법을 이용하여 심박수, 좌심 작업 지수, 전신 혈관 저항 지수, 심지수, 심박출 계수를 지혈대 착용 전 후로 순차적으로 측정하였으며 평균동맥압은 Sirecust 1260®를 이용하여 측정하였다. 결과 : 공기지혈대 제거 후 평균 동맥압은 LC군에서, 전신 혈관 저항 지수는 LC군과 LS군에서 감소함을 보였고, 심박수의 증가는 LC군과 AC에서 보였다. 결론 : 본 실험에서는 공기지혈대의 착용 전 후로 유의한 혈역학적 변화가 있음이 관찰 되었고 이는 마취과 의사가 관심을 가져야 할 것으로 사료된다. Background : The hemodynamic changes such as hypotension, tachycardia and acidosis have been reported when pneumatic tourniquet was deflated. The authors evaluated more detailed hemodynamic parameters about cardiac index(CI), left cardiac work index(LCWI), systemic vascular resistance index(SVRI) and ejection fraction(EF) with bioimpedance method. Methods : Forty four ASA class Ⅰ or Ⅱ patients underwent elective orthopedic surgery are divided into 3 groups. Pneumatic tourniquet was applied to patient's lower extremity with general anesthesia (LG, n=22), lower extremity with spinal anesthesia (LS, n=10) and upper extremity with general anesthesia(AG, n=12) respectively. We observed herat rate (HR), CI, LCWI, SVRI and EF to be changed by bioimpedance technique, mean arterial pressure was measured by automated oscillotonometry. Results: After tourniquet deflation, MAP was decreased significantly in LG group, HR was increased signifaicantry in LG and LS group and SVRI was decreased significantly in LG and AG group. Conclusions: we suggest that hemodynamic changes occur after tourniquet deflation. Therfore, these changes can be of clinical importance.
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지혈대 내측의 포비돈-요오드 용액에 의한 화학 화상 (1예 보고)
원종경,이강,Won, Jong-Kyoung,Lee, Kang 대한족부족관절학회 2012 대한족부족관절학회지 Vol.16 No.3
In the extremity surgery, pneumatic tourniquet and povidone-iodine solution are commonly used to provide an aseptic, bloodless field, and their complication rate has remained low. However, chemical burn under tourniquet has been rarely reported. Patients sustained burn injuries over the dependent, weight-bearing regions such as posterior neck, back, buttocks and posterior thighs. This rare adverse complication occurred in a 22-year-old man who underwent modified Brostrom operation with arthroscopic os trigonum excision. 10% povidone-iodine was used as topical antiseptic, and full thickness burn occurred underneath the area of tourniquet application. Main causes of povidone-iodine related chemical burn are considered maceration, irritation of the skin, long term use of the tourniquet and pressure. To reduce the complications like chemical burn, awareness of the risk and the possible pathogenesis as well as the preventive measures is important in surgical practice.
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Rhabdomyolysis after the free fibular flap operation for mandibular reconstruction: a case report
Choi, Won-Hyuk,Kim, Yong-Deok,Song, Jae-Min,Lee, Jae-Yeol Korean Association of Maxillofacial Plastic and Re 2018 Maxillofacial Plastic Reconstructive Surgery Vol.40 No.-
Background: Free fibular flap is one of the most useful methods in the hard tissue reconstruction of the maxillamandible. Free fibular flap presents some advantages in which the reconstruction of both soft and hard tissues can be done at the same time. It also provides a safe and successful bone graft for the reconstruction, along with a low rate of complications. Despite these advantages and the rarity of a postoperative complication, particularly in oral and maxillofacial surgery procedures, a prolonged operation might exhibit some complications related with rhabdomyolysis. We experienced the rare event of rhabdomyolysis after oral cancer surgery. Case presentation: In this article, we report the case of a patient who developed rhabdomyolysis after undergoing free fibular flap surgery. Conclusions: Despite the advantages of the free fibular flap operation, clinicians must be aware of the risk of complications because there are multiple factors that could result in rhabdomyolysis, such as duration of operation, position of the subject, and pre-existing conditions of diabetes and hypertension. Once the diagnosis of rhabdomyolysis is confirmed, a prompt treatment plan should be made and applied as soon as possible. This will increase the chance of a full recovery for the patient who is exhibiting symptoms of rhabdomyolysis.
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