Worland R L, Arredondo J, Angles F, Lopez-Jimenez F, Jessup D E
Advanced Orthopaedic Centers, Health South Medical Center, Richmond, Virginia 23294, USA.
J Arthroplasty. 1997 Dec;12(8):848-52. doi: 10.1016/s0883-5403(97)90153-4.
Thigh pain following tourniquet application is a common patient complaint in the early postoperative period following total knee arthroplasty. Postoperative thigh pain was evaluated in 28 consecutive simultaneous bilateral total knee arthroplasty patients between April 1996 and October 1996. A prospective, double-blind, randomized clinical trial was performed. Tourniquet pressure of 350 mmHg was used on 1 thigh (thigh 1) and 100 mmHg plus systolic blood pressure on the other (thigh 2). A scale of pain (no pain, mild, moderate, or severe) was applied on the first, second, and third days, as well as 2 and 6 weeks after surgery. There were 16 men and 12 women with a mean age of 72 years (range, 55-85 years). The mean tourniquet time was similar in both groups (thigh 1 = 23 minutes, thigh 2 = 22 minutes). The mean tourniquet pressure in thigh 2 was 230 mmHg (range, 212-260 mmHg). There was a statistically significant difference in thigh pain on the first (P = .01), second (P = .01), and third (P = .001) postoperative days between both groups, with more thigh pain on the 350 mmHg side. At 6 weeks after surgery, the difference in thigh pain was gone. For total knee arthroplasty, using the tourniquet at a pressure of 100 mmHg above the systolic blood pressure is recommended. This is adequate to provide a bloodless field and will result in a less unpleasant postoperative period.
在全膝关节置换术后的早期，使用止血带后出现大腿疼痛是患者常见的主诉。对1996年4月至1996年10月期间连续28例同时进行双侧全膝关节置换术的患者的术后大腿疼痛情况进行了评估。开展了一项前瞻性、双盲、随机临床试验。一侧大腿（大腿1）使用350 mmHg的止血带压力，另一侧（大腿2）使用100 mmHg加上收缩压的压力。在术后第1天、第2天、第3天以及术后2周和6周应用疼痛量表（无疼痛、轻度、中度或重度）。有16名男性和12名女性，平均年龄72岁（范围55 - 85岁）。两组的平均止血带使用时间相似（大腿1 = 23分钟，大腿2 = 22分钟）。大腿2的平均止血带压力为230 mmHg（范围212 - 260 mmHg）。两组在术后第1天（P = .01）、第2天（P = .01）和第3天（P = .001）的大腿疼痛存在统计学显著差异，350 mmHg一侧的大腿疼痛更严重。术后6周时，大腿疼痛的差异消失。对于全膝关节置换术，建议使用高于收缩压100 mmHg的压力使用止血带。这足以提供无血视野，并将使术后时期不那么令人不适。
