Cambios hemodinámicos transitorios asociados a la liberación del manguito neumático en la artroplastia total de rodilla: un estudio multicéntrico retrospectivo

Background The release of a pneumatic tourniquet during total knee arthroplasty (TKA) causes an abrupt increase in blood flow to the lower limb, which may result in transient hemodynamic instability. The aim of this study was to quantify the magnitude and duration of these changes in a real-world clinical setting.Methods A multicenter retrospective observational study was conducted including 149 patients undergoing primary TKA under pneumatic tourniquet ischemia. Systolic (SBP), diastolic (DBP), and mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR), and oxygen saturation (SpO2) were recorded at three time points: baseline (pre-release), 3minutes (T3), and 6minutes (T6) after tourniquet release. Statistical analysis was performed using repeated-measures ANOVA or the Friedman test, according to data distribution, with pResults Following tourniquet release, a significant immediate decrease in SBP and DBP was observed (p2 decreased slightly (p=0.034) without clinical relevance. Transient arrhythmias were recorded in 8.7% of patients. At 6minutes post-release, all parameters returned to baseline values.Conclusion Tourniquet release during TKA is associated with transient hemodynamic changes and early recovery. These findings support the need for reinforced monitoring in patients classified as ASA III and/or with ischemia times longer than 85minutes, and provide a rationale for future prospective studies incorporating advanced hemodynamic monitoring.Level of evidence Level III, retrospective study.