A Case of Rhabdomyolysis Associated with Use of a Pneumatic Tourniquet during Arthroscopic Knee Surgery
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The common causes of rhabdomyolysis include trauma, hypoxia, drugs, toxins, infections and hyperthermia. Operative insults, including direct trauma and ischemia, have the potential to cause the development of rhabdomyolysis. Pneumatic tourniquets used during arthroscopic knee surgery to prevent blood loss have led to many complications such as nerve paralysis and vascular injuries. Rhabdomyolysis can also be caused by prolonged pneumatic tourniquet application without a midapplication release, and also from an increased application pressure, but the actual incidence of this is low. In order to prevent rhabdomyolysis, the clinicians must be aware of such risks and follow strict guidelines for the application time, the midapplication release and also the inflation pressure. Vigorous hydration and postoperative patient surveillance are helpful to prevent rhabdomyolysis. We have recently experienced a case of rhabdomyolysis after the arthroscopic knee surgery, and the rhabdomyolysis could have been associated with the use of a pneumatic tourniquet. (Korean J Intern Med 2010;25:105-109)
Abstract
The common causes of rhabdomyolysis include trauma, hypoxia, drugs, toxins, infections and hyperthermia. Operative insults, including direct trauma and ischemia, have the potential to cause the development of rhabdomyolysis. Pneumatic tourniquets used during arthroscopic knee surgery to prevent blood loss have led to many complications such as nerve paralysis and vascular injuries. Rhabdomyolysis can also be caused by prolonged pneumatic tourniquet application without a midapplication release, and also from an increased application pressure, but the actual incidence of this is low. In order to prevent rhabdomyolysis, the clinicians must be aware of such risks and follow strict guidelines for the application time, the midapplication release and also the inflation pressure. Vigorous hydration and postoperative patient surveillance are helpful to prevent rhabdomyolysis. We have recently experienced a case of rhabdomyolysis after the arthroscopic knee surgery, and the rhabdomyolysis could have been associated with the use of a pneumatic tourniquet. (Korean J Intern Med 2010;25:105-109)
참고문헌 (10)
- Bywaters EG, "Crush injuries with impairment of renal function: 1941", J Am Soc Nephrol, 9, pp.322~332 (1998)
- Kim HY, "Analysis of 250 cases of rhabdomyolysis", Korean J Nephrol, 13, pp.810~817 (1994)
- Prabhu M, "An unusual cause of rhabdomyolysis following surgery in the prone position", J Neurosurg Anesthesiol, 12, pp.359~363 (2000)
- Murphy CG, "Tourniquet injuries : pathogenesis and modalities for attenuation", Acta Orthop Belg, 71, pp.635~645 (2005)
- Shenton DW, "Tourniquet-induced rhabdomyolysis: a case report", J Bone Joint Surg Am, 72, pp.1405~1406 (1990)
- Sheth NP, "Rhabdomyolysis and acute renal failure following arthroscopic knee surgery in a college football player taking creatine supplements", Clin Nephrol, 65, pp.134~137 (2006)
- Palmer SH, "Tourniquet-induced rhabdomyolysis after total knee replacement", Ann R Coll Surg Engl, 76, pp.416~417 (1994)
- Schwartz JT Jr, "Acute compartment syndrome of the thigh: a spectrum of injury", J Bone Joint Surg Am, 71, pp.392~400 (1989)
- Vold PL, "Rhabdomyolysis from tourniquet trauma in a patient with hypothyroidism", West J Med, 162, pp.270~271 (1995)
- Sapega AA, "Optimizing tourniquet application and release times in extremity surgery: a biochemical and ultrastructural study", J Bone Joint Surg Am, 67, pp.303~314 (1985)