[The significance of the pneumatic tourniquet technique for an innovative varicose vein surgery--methods, advantages, risks, danger].
OBJECTIVE
The systemic effects of the pneumatic tourniquet technique in varicose vein surgery were studied in order to evaluate possible risks and threats.


METHODS
155 patients were included to look at intraoperative changes of cardiovascular parameters and capillary blood and respiratory gases.


RESULTS
Whereas the pulse rate showed only an insignificant rise of 3/min, the systolic and diastolic blood pressure increased significantly by 12 and 6 mm Hg resp., after inducing ischemia by roller cuff. After removal of the roller cuff blood pressure decreased by 14 and 9 mm Hg, resp., again. At releasing of the ischemia, pH values drop by 0.02, and the base excess by 0.3 mval/L with operation on one side and 0.5 mval/L in both sides operation. In comparison, the capillary pCO 2 rose by 3 mm Hg and the pCO 2 of the respiratory air by 1 mm Hg in one side operation and 3 mm Hg, resp. in operation of both sides. The pressure in the roller cuff was in the middle only 55 mm Hg above systemic pressure values.


CONCLUSIONS
The systemic effects of the tourniquet technique have no clinical relevance. The use of the pneumatic tourniquet (Loefqvist method) is unrestrictedly recommended due to its advantages, such as no intraoperative blood loss, avoidance of post-op haematoma and pain and good immediate cosmetic results.
Lahl
W
W
Gefässchirurgische Abteilung, St. Willehad Hospital Wilhelmshaven. Wolfgang.Lahl@dgn.de
Lehmann
M
M
Kurth
M
M
Hofman
B
B
D000136:Acid-Base Equilibrium / Q000502:physiology; D000328:Adult; D000368:Aged; D002245:Carbon Dioxide / Q000097:blood; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology* / Q000503:physiopathology; D007866:Leg / Q000098:blood supply; D008297:Male; D008833:Microcirculation / Q000503:physiopathology; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D012307:Risk Factors; D013525:Surgical Instruments; D014111:Tourniquets; D014648:Varicose Veins / Q000601:surgery*
D002245:Carbon Dioxide; D010100:Oxygen