Bilateral Passive Leg Raising Attenuates and Delays Tourniquet Deflation Induced Hypotension and Tachycardia in Lower Limb Surgeries Under Spinal Anaesthesia : A Randomised Controlled Trial

Abstract

BACKGROUND Lower limb orthopaedic surgeries and ligament reconstruction surgeries are often done with touniquet applied under spinal anaesthesia. Tourniquet deflation leads to the redistribution of the circulating volume back into the limb and post ischaemic reactive hyperaemia. The passive leg raising (PLR) test has been proposed as a predictor of fluid responsiveness in critically ill patients. PLR induces a rapid increase in preload because of the auto transfusion of blood contained within the capacitance veins of the legs. Hence we thought it worthwhile to study the effect of bilateral PLR on patient’s blood pressure and heart rate after tourniquet deflation in patients undergoing lower limb surgery under spinal anaesthesia.