Expert: Ronald Levy, M.D. - 12/7/2010

Question
Hi,  my husband recently had an arthroscopy on his knee to treat synovitis,  the surgeon used a tourniquet for 1 hour plus during the time it was recorded that his blood pressure was significantly high (120/100) his was given more propofol and a betablocker and a ACE inhibitor .  My question is is this normal practice.
Thank you in advance!

Answer
All of the things you mention are normal practice. The surgeon uses a tourniquet to minimize bleeding so he can see inside the joint. The tourniquet can be up for 2 hrs before any significant problems occur. The medications to treat the BP are also reasonable. The tourniquet can sometimes cause high BP secondary to pain. That explains the Propofol. The beta blocker and ACE inhibitor treat high BP secondary to intrinsic causes (I am assuming he does not have a history of hypertension).

Hope this helps,

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston