Document Type : Original Article
Department of Anesthesia and Intensive Care, Faculty of Medicine, Mansoura University, Egypt
Background: Deflation of the pneumatic tourniquet after orthopedic surgery is associated with multiple cardiovascular adverse effects [hypotension and tachycardia]. Trendelenburg position or passive leg raising [PLR] are commonly used as the initial treatment of shock and hypotension
Aim of the work: To compare between Trendelenburg position 20˚ and passive leg raising 45° regarding the incidence of post-tourniquet deflation cardiovascular adverse effects in patients undergoing unilateral knee arthroscopy.
Patients and methods: This prospective study included 98 cases that underwent unilateral knee arthroscopy. Patients were randomly allocated into two groups; group  included 49 cases who were exposed to the Trendelenburg position after deflation, and group  included the remaining cases who had the straight leg raising test after deflation. Mean arterial pressure, heart rate, and need for vasoactive substances were recorded.
Results: No significant difference was noticed between the two groups regarding demographic variables, heart rate before tourniquet deflation, and one-minute after its deflation. However, there was a significant difference between the same groups on the subsequent readings apart from the last one. Also, group  showed significantly higher mean arterial pressure [MAP] compared to group  after deflation. Hypotension was more significantly encountered in group , and thus ephedrine requirements were increased.
Conclusion: Trendelenburg position appears to be more efficacious when compared to the straight leg raising, regarding the prevention of cardiovascular adverse effects associated with deflation.