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Purpose of pneumatic compression device9/17/2023 ![]() In addition, the effects may be predominant in elderly patients. We hypothesized that the use of pneumatic compression of the lower extremities would decrease hemodynamic instability during anesthesia induction and the effects may be different by the types of compression. Several types of pneumatic compression of the lower extremities, including pneumatic splint, intermittent compression, peristaltic compression, sequential compression, and military anti-shock trouser (MAST) are established interventions for various indications such as lymphedema, postthrombotic ulcers, arterial claudication, deep vein thrombosis, and severe trauma. Many previous reports have shown that the effects of pneumatic compression on the prevention of anesthesia- or position-related hypotension resulted from the peripheral redistribution of central blood volume. However, external compression of the lower extremities decreases the peripheral pooling of blood and augments venous return to increase central blood volume. Although Trendelenburg positioning or passive legraising is a simple maneuver to increase the blood in the central compartment to restore cardiac preload, it is not feasible in many clinical situations. Therefore, prevention of the redistribution of blood during anesthesia might be a good option to avoid hemodynamic instability and the adverse effects of intravenous fluids and cardiovascular active agents. Additionally, the administration of ephedrine has a risk of myocardial ischemia due to severe tachycardia. However, many previous reports have shown the risks of fluid overload although the role of perioperative fluid management remains under debate. In clinical practice, large volumes of fluid or short-acting cardiovascular active agent such as ephedrine may be administered to counteract anesthesia-induced hypotension. ![]() Consequently, blood pressure drops result from decreased cardiac output and SVR during general anesthesia induction. Also, positive pressure ventilation decreases cardiac output result from effects on the right heart. ![]() The redistribution may decrease cardiac preload and results in a decrease in the stroke volume (SV) according to the Frank-Starling’s law. Because anesthetics redistribute the blood from the central to the peripheral compartment secondary to vasodilatation for the reasons above, hemodynamic instability is common during the induction of general anesthesia and preparation for operation. Furthermore, anesthesia decrease sympathetic activity before surgical stimulation. The effect of anesthetics decrease systemic vascular resistance (SVR) and venous return. Modern anesthetics have vasodilatory effect with minimal myocardial depression. ![]()
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