Morrison D S, Schaefer R K, Friedman R L
Southern California Center for Sports Medicine, Long Beach 90806, USA.
Arthroscopy. 1995 Oct;11(5):557-60. doi: 10.1016/0749-8063(95)90131-0.
Twenty-two consecutive patients with subacromial impingement syndrome underwent arthroscopic subacromial decompression. Measurements of the subacromial space pressure and the blood pressure were recorded along with the clarity of the visual field. The clarity of the visual field was objectively determined based on the pressure at which bleeding was observed from trabecular bone or the soft tissue capillaries. A direct correlation was found between systolic blood pressure (SBP), subacromial space pressure (SASP), and the clarity of the visual field. On average, maintaining a pressure difference (SBP-SASP) of 49 mm Hg or less prevented bleeding and permitted good visualization. With a greater differential, significant bleeding occurred. Furthermore, the use of relative hypotensive anesthesia permits lower irrigation pressures and significantly reduces the risk of fluid extravasation into the subcutaneous tissues of the shoulder.
22例连续的肩峰下撞击综合征患者接受了关节镜下肩峰下减压术。记录肩峰下间隙压力、血压以及视野清晰度。视野清晰度是根据从小梁骨或软组织毛细血管观察到出血时的压力客观确定的。发现收缩压（SBP）、肩峰下间隙压力（SASP）与视野清晰度之间存在直接相关性。平均而言，保持49毫米汞柱或更低的压力差（SBP - SASP）可防止出血并实现良好的视野。压力差更大时，会发生明显出血。此外，使用相对低血压麻醉可允许更低的冲洗压力，并显著降低液体渗入肩部皮下组织的风险。
