Effect of Preoperative Antianxiety Medications on Blood Pressure and Blood Loss in Total Knee Arthroplasty: A Case-Control Study.

IF 1.2 Q3 ORTHOPEDICS
Zuhdi O Elifranji, Jihad M Al-Ajlouni, Munther G Al-Saber, Yazan S Hammad, Basel A Baniatta, Sara N Alshoubaki, Mohammad S Jabaiti, Ahmad M Alkhatib, Abdelrahman M Abu Awad, Abdelrahman E Altarazi, Aseel N Abdin, Abdallah Al-Ani, Mohammad Ali Alshrouf
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引用次数: 0

Abstract

Background: The increasing number of canceled operations in patients undergoing total knee arthroplasty (TKA) due to high blood pressure readings has put a considerable burden on surgeons. In this study, we aim to assess the effect of giving antianxiety drugs preoperatively on maintaining blood pressure (BP) and blood loss for patients undergoing TKA surgery.

Methods: This retrospective case-control study included patients who underwent total knee arthroplasty and divided them into two main groups: those who had taken a 3 mg bromazepam oral tablet at the night preoperatively and the control group. The blood pressure of patients was then measured preoperatively (baseline), in the morning of surgery, in the operating room before anesthesia, and during the surgery. The percentage of measured BP was calculated by dividing the measured BP by the baseline, then multiplying by 100.

Results: 301 patients were included in our study: 137 received bromazepam and 164 as a control group. The ratio of systolic BP (SBP) in the morning of surgery to the baseline (percentage of morning SBP) decreased significantly in the bromazepam group compared with the controls. The ratio of SBP, in the operating room before anesthesia (percentage of preanesthesia SBP) also decreased significantly in the bromazepam group. However, the percentage of SBP in the middle of surgery did not change significantly. In addition, there was a significant difference change from the baseline in diastolic BP and mean arterial BP between the two groups in the morning of surgery, inside the theatre, and in the middle of the operation. The bromazepam group also showed a significant decrease in blood loss.

Conclusion: Preoperative oral antianxiety drugs (bromazepam) helps in controlling hemodynamic changes associated with anxiety, including maintaining BP in well-controlled hypertensive and healthy patients undergoing TKA, and it plays a role in decreasing the total blood loss.

Abstract Image

术前抗焦虑药物对全膝关节置换术中血压和失血量的影响:一项病例对照研究。
背景:越来越多的接受全膝关节置换术(TKA)的患者由于血压升高而取消手术,这给外科医生带来了相当大的负担。在本研究中,我们旨在评估术前给予抗焦虑药物对TKA手术患者维持血压和出血量的影响。方法:本回顾性病例对照研究纳入全膝关节置换术患者,并将其分为两组:术前夜间口服丙西泮片3mg组和对照组。然后在术前(基线)、手术当天早晨、麻醉前在手术室和手术中测量患者的血压。测量的血压百分比通过将测量的血压除以基线,然后乘以100来计算。结果:本研究共纳入301例患者,其中137例给予溴西泮治疗,164例作为对照组。与对照组相比,术后晨间收缩压(SBP)与基线(晨间收缩压百分比)的比值显著降低。麻醉前手术室收缩压比(占麻醉前收缩压的百分比)在溴西泮组也明显降低。然而,手术中期收缩压百分比没有明显变化。此外,两组患者术中、术中、晨间舒张压、平均动脉压与基线比较差异有统计学意义。溴西泮组的失血量也显著减少。结论:术前口服抗焦虑药物(溴西泮)对控制良好的高血压患者和健康患者行TKA患者具有控制焦虑相关血流动力学改变的作用,包括维持血压,并具有减少总失血量的作用。
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来源期刊
CiteScore
2.40
自引率
0.00%
发文量
36
审稿时长
21 weeks
期刊介绍: Advances in Orthopedics is a peer-reviewed, Open Access journal that provides a forum for orthopaedics working on improving the quality of orthopedic health care. The journal publishes original research articles, review articles, and clinical studies related to arthroplasty, hand surgery, limb reconstruction, pediatric orthopaedics, sports medicine, trauma, spinal deformities, and orthopaedic oncology.
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