Incidence and factors influencing tourniquet pain

Kamath, Surendra Umesh and *, Purnachandra Tejaswi and Kamath, Krithika (2021) Incidence and factors influencing tourniquet pain. Chinese Journal of Traumatology, 24 (5). pp. 291-294. ISSN 10081275

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Abstract

Purpose: The use of tourniquet in orthopedic surgery facilitates operation by establishing a bloodless surgical field. However, many complications following the use of tourniquets have been reported. Tourniquet pain is the most common complication. This study aimed to find the actual incidence of pain associated with tourniquet use in orthopedic surgery and the various factors. Methods: It is a prospective observational study conducted on 132 consecutive cases. Patients aged 18-70 years with musculoskeletal problems of the forearm and leg requiring surgery were included in the study. Patients with open injuries or contraindications such as diabetes mellitus, compromised circulatory states, neurological deficit, compartment syndrome and unable to give informed consent were excluded. The parameters assessed included duration of tourniquet use, tourniquet pressure, type of anesthesia, any interval release of the tourniquet and reapplication after a reperfusion period, whether upper or lower limb surgery, severity of tourniquet pain, timing of tourniquet release and complications. Chi-square and non-parametric Mann-Whitney U test were used for data analysis. Results: In upper limb surgeries, if duration of surgery was less than 60 min, 14 (51.8%) cases experienced tourniquet pain and 13 (48.1%) had no pain, and if duration of surgery was more than 60 min, 24 (60.0%) had pain and 16 (40.0%) experienced no pain. In lower limb surgeries if duration of surgery was less than 60 min, 2 (7.7%) experienced pain and 24 (92.3%) had no pain, and if duration of surgery was more than 60 min, 14 (35.8%) experienced pain and 25 (64.8%) had no pain. Degree of tourniquet pain increases with the duration of surgery. Statistically, there was significant association between tourniquet inflation time and tourniquet pain in both upper and lower limbs (p ¼ 0.034 and 0.024, respectively) Conclusion: Incidence of tourniquet pain was in direct proportion to the duration of tourniquet use and was higher in cases with regional anesthesia. Other risk factors assessed including tourniquet pressure, upper or lower limb surgery, tourniquet release time and interval had no significant contribution to the incidence or severity of tourniquet pain. © 2021 Chinese Medical Association. Production and hosting by Elsevier B.V. This is an open access article under the CC BY-NC-ND license

Item Type: Article
Uncontrolled Keywords: Tourniquet pain Pneumatic tourniquet Bloodless field Orthopedic surgery Complications Pain intensity
Subjects: Medicine > KMC Mangalore > Orthopaedics
Depositing User: KMCMLR User
Date Deposited: 17 Dec 2021 11:03
Last Modified: 17 Dec 2021 11:03
URI: http://eprints.manipal.edu/id/eprint/157800

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