Blood Loss in Tka Under Tourniquet Control, Will It Lead to Haemodynamic Instability

Abstract

BACKGROUNDTotal knee arthroplasty is one of the major surgeries, where considerable haemorrhage should be expected leading to haemodynamic instability and subsequent delay in ambulation and recovery. The soft tissue release and bone cuts required for TKA are the major sites from which haemorrhage is expected. MATERIALS AND METHODSOur study is to know the blood loss following TKA in our case series, and at what severity it can lead to postoperative blood transfusions and whether it can lead to haemodynamic instability or not with the given perioperative protocol. Blood loss is analysed in the groups with above and below average Hb and PCV with continuous tachycardia and hypotension. RESULTSOut of 168 patients in study group requirement for blood transfusion is for 93 cases, requiring transfusion with tachycardia and fall in BP and 5 cases requiring transfusion in both the below-above mean group of Hb and PCV respectively. CONCLUSIONThe haematocrit changes seen postoperatively are dependent on the haemodilution, going by the drop in Hb and PCV seen in both groups undergoing the same surgery with same indication, same approach, same surgeon and implant, even when the Hb and PCV levels are normal.