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Evaluación del sangrado y tiempo quirúrgico en artroplastía total de rodilla con y sin torniquete: Estudio comparativo / Assessment of bleeding and operative time in total knee arthroplasty with and without tourniquet: Comparative study
Arcia-Guzmán, A; Bernabé-Castañeda, E; Arcia-Guzmán, JJ; Olguín-Montoya, JM.
  • Arcia-Guzmán, A; Centro Médico ISSEMYM Ecatepec.
  • Bernabé-Castañeda, E; Centro Médico ISSEMYM Ecatepec.
  • Arcia-Guzmán, JJ; Centro Médico ISSEMYM Ecatepec.
  • Olguín-Montoya, JM; Centro Médico ISSEMYM Ecatepec.
Acta ortop. mex ; 28(2): 106-112, mar.-abr. 2014. tab
Article in Spanish | LILACS | ID: lil-720711
RESUMEN
Antecedentes La utilización de torniquete neumático (TN) en la artroplastía total de rodilla (ATR) ha sido tema de controversia, describiendo ventajas, desventajas y complicaciones asociadas. Con la finalidad de evaluar los beneficios de su utilización se estudió el tiempo quirúrgico, volumen de sangrado transquirúrgico, postquirúrgico y total, así como los valores de hemoglobina y hematocrito pre y postquirúrgicos de pacientes a los que se les realizo ATR primaria utilizando TN y se compararon con un grupo control. Material y

métodos:

Se realizó un análisis retrospectivo de expedientes clínicos de casos sometidos a ATR; en apego a los criterios de inclusión se obtuvo un grupo de estudio (n = 19) y control (n = 19) según la utilización o no de TN. Se compararon el tiempo quirúrgico, el sangrado transquirúrgico y postquirúrgico así como el sangrado total; valores de hemoglobina y hematocrito iniciales y finales.

Resultados:

Se obtuvieron diferencias significativas a favor del grupo en quienes se utilizó TN en 7 de 8 variables estudiadas, siendo el tiempo empleado (t = 2.08 p < 0.050); sangrado transquirúrgico (t = -6.44, p < 0.010); postquirúrgico (t = -2.170 p < 0.050) y total (t = /7.52, p < 0.010), las más relevantes.

Conclusiones:

Los resultados mostraron que los sujetos a quienes se les aplicó TN durante la ATR requirieron menos tiempo quirúrgico y que el sangrado total, trans y postquirúrgico, así como la perdida sanguínea calculada fueron menores que los controles. Mayores conjeturas sobre los beneficios del TN ameritan la realización de más investigaciones prospectivas.
ABSTRACT

Background:

The use of the pneumatic tourniquet (PT) in total knee arthroplasty (TKA) has been controversial; its advantages, disadvantages and associated complications have been described. In order to assess its benefits we analyzed operative time; intraoperative, postoperative and total bleeding volume, as well as pre- and postoperative hemoglobin and hematocrit values in patients who had undergone primary TKA using the PT, and they were compared with a control group. Material and

methods:

A retrospective analysis of the clinical records of cases who underwent TKA was conducted. Based on the inclusion criteria and the use or non-use of PT, two groups were formed a study group (n = 19) and a control group (n = 19). The following variables were compared operative time, intra and postoperative bleeding and total bleeding; initial and final hemoglobin and hematocrit values.

Results:

Significant differences in favor of the group with PT use were obtained in 7 out of the 8 variables studied. The most relevant ones were operative time (t = 2.08 p < 0.050); intraoperative bleeding (t = -6.44, p < 0.010); postoperative bleeding (t = -2.170 p < 0.050) and total bleeding (t = /7.52, p < 0.010).

Conclusions:

The results showed that patients in whom PT was used during TKA had a shorter operative time, and their total, intra- and postoperative bleeding and the estimated blood loss were lower than in controls. Additional suppositions on the benefits of PT warrant the conduction of more prospective research studies.
Subject(s)

Full text: Available Index: LILACS (Americas) Main subject: Tourniquets / Blood Loss, Surgical / Postoperative Hemorrhage / Arthroplasty, Replacement, Knee Type of study: Observational study / Risk factors Limits: Adult / Aged / Aged80 / Female / Humans / Male Language: Spanish Journal: Acta ortop. mex Journal subject: Ferimentos e Lesäes / Orthopedics Year: 2014 Type: Article Affiliation country: Mexico

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Full text: Available Index: LILACS (Americas) Main subject: Tourniquets / Blood Loss, Surgical / Postoperative Hemorrhage / Arthroplasty, Replacement, Knee Type of study: Observational study / Risk factors Limits: Adult / Aged / Aged80 / Female / Humans / Male Language: Spanish Journal: Acta ortop. mex Journal subject: Ferimentos e Lesäes / Orthopedics Year: 2014 Type: Article Affiliation country: Mexico