Metabolic Responses to Tourniquet Release in Children

The effects of propofol or halothane on free radical production after tourniquet induced ischaemia‐reperfusion injury during knee arthroplasty

“…Although skeletal muscle is thought to be relatively insensitive to the deleterious effects of ischaemia and subsequent reperfusion, injury can occur as a result of prolonged ischaemia. Numerous studies are found in the literature concerning the local, systemic, metabolic and morphological effects of pneumatic tourniquets on skeletal muscles (14–20). The effects of continuous tourniquet application were shown to be temporary as long as the duration does not exceed 2 h (19).…”

EtCO2 Changes After Tourniquet Deflation in Orthopaedic Surgeries

“…Increase in end tidal carbon dioxide (EtCO2) and heart rate, decrease in mean arterial pressure following tourniquet release has been reported in adults as well as in children. [5,6] These changes can be reduced with minimum duration of tourniquet, monitoring of EtCO2, and controlled ventilation. Monitoring of pulse, BP, ECG, respiratory status, and neurological status are important when the tourniquet is being deflated.…”

Medical assessment of the paediatric patient

“…Mild metabolic acidosis and an increase in serum lactate occurs during and soon after release of the tourniquet because of the resultant stasis and tissue acidosis. 8 If a tourniquet is essential then the limb must be carefully exsanguinated and the tourniquet used for the minimum time necessary. When used carefully, there is no additional morbidity associated with tourniquet use in patients with sickle cell trait.…”