Limb occlusion pressure versus standard tourniquet inflation pressure in minor hand surgery: a randomized controlled trial
Issued Date
2023-12-01
Resource Type
eISSN
1749799X
Scopus ID
2-s2.0-85165958698
Pubmed ID
37507745
Journal Title
Journal of Orthopaedic Surgery and Research
Volume
18
Issue
1
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Orthopaedic Surgery and Research Vol.18 No.1 (2023)
Suggested Citation
Kanchanathepsak T., Pukrittayakamee N.C., Woratanarat P., Tawonsawatruk T., Angsanuntsukh C. Limb occlusion pressure versus standard tourniquet inflation pressure in minor hand surgery: a randomized controlled trial. Journal of Orthopaedic Surgery and Research Vol.18 No.1 (2023). doi:10.1186/s13018-023-04000-3 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/88231
Title
Limb occlusion pressure versus standard tourniquet inflation pressure in minor hand surgery: a randomized controlled trial
Author's Affiliation
Other Contributor(s)
Abstract
Background: In minor hand surgery, tourniquet is typically inflated to 250 mmHg. The pressure may be too high and cause unnecessary adverse effects. Limb occlusion pressure plus safety margin or recommended tourniquet pressure (RTP), has been reported as optimal pressure to provide bloodless field in limb surgeries. This study aimed to compare the RTP with the standard tourniquet pressure of 250 mmHg in minor hand surgery. Methods: A double-blinded randomized control trial was conducted from July to December 2019 and June 2020 to May 2021. Patients were randomly assigned into two groups: RTP and 250 mmHg with 3:1 ratio allocation. The outcomes were measurement of cuff pressure reduction, time to develop of tourniquet pain and discomfort, pain score, discomfort score, motionless and bloodless of operative field determined by the surgeon’s satisfaction. Results: A total of 112 patients were included, 84 were in RTP and 28 were in 250 mmHg group. Mean of tourniquet pressure was significantly lower in the RTP group (228.3 ± 17.2 mmHg) (P < 0.001). Even though, time to develop pain was not significantly different, the RTP group reported significantly less pain and discomfort, according to the pain score (P = 0.02) and discomfort score (P = 0.017). The RTP group provided better motionless field, while both groups equally created a bloodless field. Conclusion: The RTP significantly reduced tourniquet related pain and discomfort during minor hand surgeries. It provided better motionless operative field and adequate bloodless field. Therefore, the RTP should be considered as optimal tourniquet pressure for minor hand surgeries. Trial registration : TCTR20210519001 (retrospectively registered). Level of evidence: I.