Experiments have been carried out on rhesus monkeys to determine the effect of the application of a pneumatic tourniquet on the ultrastructure of the muscles of the lower limb. Tourniquets were applied for periods lasting between one and five hours. The changes in the muscle lying immediately under the cuff of the tourniquet were more marked than those observed in muscle distal to the cuff. Thr...

Distributions of tissue fluid pressure were examined beneath a standard pneumatic tourniquet in six upper extremities and six lower extremities of fresh human cadavera, disarticulated at the shoulder and hip, respectively. A standard 8-cm-wide tourniquet cuff was applied at mid-humerus or mid-femur position. Tissue fluid pressures were measured by 100-cm-long slit catheters inserted parallel to...

PURPOSE To choose the best arterial tourniquet for angioaccess surgery. METHODS Preventive hemostasis with an arterial tourniquet prevents bleeding and provides better visualization. The surgeon may currently use a traditional wide nonsterile inflatable pneumatic cuff after exsanguination with an Esmarch bandage or a disposable sterile narrow elastic silicone ring (HemaClear®), available in d...

BACKGROUND Tourniquet cuff pressures in pediatric patients are commonly set at standard pressures. Recent evidence on adult subjects has shown that safer and more effective cuff pressures can be achieved by measuring limb occlusion pressure (LOP) and using a wide contour cuff. There is little evidence validating these techniques in children. The primary objective of this study was to evaluate i...

BACKGROUND A bloodless operative field is considered mandatory for most surgical procedures on the upper and lower extremity. This is accomplished by using either an Esmarch bandage or a pneumatic tourniquet, but a number of complications are associated with both. Nerve palsy is one of the most frequently encountered complications of this procedure. Wider cuffs have been found to cause reduced ...

BACKGROUND Studies have shown that vein size is an important predictor of successful ultrasound-guided vascular access. The objective of this study is to evaluate maneuvers designed to increase basilic vein size, which could be used to facilitate ultrasound-guided peripheral intravenous access (USGPIV) in the Emergency Department (ED) setting. METHODS This was a prospective non-randomized tri...

Background: Measurement of limb occlusion pressure before surgery might lead to the use of a lower tourniquet cuff pressure during surgery and thereby reduce the risk of postoperative pain and complications. The primary aim of this study was to investigate whether the limb-occlusion-pressure method reduces the tourniquet cuff pressure used during total knee arthroplasty and if this leads to les...

BACKGROUND Pneumatic tourniquets are medical devices that occlude blood flow to distal part of extremities and are commonly used in upper limb surgeries to provide a dry, clean and bloodless field. To decrease pressure-related injuries and potential risk of complications subjected to the high inflation pressure of pneumatic tourniquet, minimal inflation pressures are recommended. METHODS A ne...

BACKGROUND AND PURPOSE Tourniquet-related nerve injuries remain a concern in orthopedic surgery. The cuff pressures used today are generally lower, and therefore a decreasing incidence of peripheral nerve injuries might also be expected. However, there have been few neurophysiological studies describing the outcome after bloodless field surgery. We describe the results of neurophysiological exa...

We examined the amount of thigh tourniquet pressure that can be reduced from the typical 300 to 350 mm Hg by using a new automated plethysmographic limb occlusion pressure measurement technique. We also examined how much pressure could be reduced by using a wide contoured cuff compared with a standard cuff and if limb occlusion and systolic blood pressures were well correlated. Patients having ...