2020-06-252020-06-252019NASCIMENTO, Gabriel Augusto Remígio Lima do; VIEIRA FILHO, Paulo César Nascimento. A influência do torniquete pneumático sobre perda sanguínea, dor e edema na artroplastia total do joelho. Orientador: João Alberto Ramos Maradei Pereira. 2019. 68 f. Trabalho de Curso (Bacharelado em Medicina) - Faculdade de Medicina, Instituto de Ciências da Saúde, Universidade Federal do Pará, Belém, 2019. Disponível em:https://bdm.ufpa.br:8443/jspui/handle/prefix/3156. Acesso em:.https://bdm.ufpa.br/handle/prefix/3156Background: Total knee arthroplasty is the definitive surgical treatment for knee osteoarthritis and is intended to decrease pain and restore function. During the surgery, the use of a pneumatic tourniquet is recommended in the thigh in order to reduce total blood loss and allow a better visualization of the surgical field, improving the surgical time. However, recent studies have shown that, besides not decreasing the total blood loss, this device can generate several postoperative complications, such as muscular and nervous injuries, edema, chronic pain and thromboembolic events. Thus, the present study aimed to evaluate the influence of pneumatic tourniquet on total blood loss, pain and edema after total knee arthroplasty. Methods: A prospective, randomized, longitudinal and uniblinded clinical trial was conducted with 37 patients submitted to total knee arthroplasty for primary osteoarthritis treatment in a hospital in the city of Belém-PA, from february to October, 2018. Participants were randomly allocated in 2 groups: 1) No tourniquet, consisting of 20 individuals who did not use the pneumatic tourniquet during total knee arthroplasty; and 2) with tourniquet, made up of 17 individuals who made use of it. To evaluate the total blood loss, we analyzed the hematimetric values of the hemogram between the immediate preoperative period and 48 hours after surgery, and the total volume of bleeding was estimated by means of a pre-established calculation. Pain and edema were assessed immediate preoperatively and at 3 days, 15 days, 45 days and at 4 months postoperative. The edema was evaluated through direct measurements with tape measure of the thigh, leg and bimalleolar of the operated limb, and pain was measured using the visual analogue scale. Results: The study population consisted mostly of female individuals (83.8%), mean age of 62.4 ± 8 years and mean BMI of 29 ± 3.9. The torniquet group presented statistically more individuals affected by type 2 diabetes mellitus and shorter surgical time than those without tourniquet (p = 0.005 and p = 0.010, respectively). In the evaluation of the blood loss after 48 hours of the surgical procedure, the intergroup analysis did not identify a statistically significant difference in the decrease of hemogram values (p> 0.05) or in the calculated total blood loss (p = 0.277). There were also no statistically significant differences between groups when edema formation was assessed in the operated limb and in the pain score during the period (p> 0.05). Conclusions: It can be concluded that the use of the pneumatic tourniquet in total knee arthroplasty did not reduce surgical blood loss, but shortened surgical time. There were no differences on pain or edema with or without tourniquet.Acesso AbertoOsteoartriteArtroplastiaHemostasiaPerda sanguínea cirúrgicaCNPQ::CIENCIAS DA SAUDE::MEDICINA::ORTOPEDIA E TRAUMATOLOGIATrabalho de Curso - Graduação - Monografia