Comparison between two mathematical methods to estimate arterial occlusion pressure and tourniquet effectiveness in lower limb surgery: a prospective, randomized, double blind, comparative study

Kasem, Samaa A.; Menesy, Tarek Al; Badawy, Ahmed; Elmawgoud, Ashraf Abd; Adel, Ghada; Badawy, Yasmin A.

doi:10.1007/s10877-019-00366-0

Cited by 4 publications

(4 citation statements)

References 18 publications

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“…In this study, Tuncali and his colleagues measured the tissue pressure under the tourniquet (TPUT) and tourniquet inflation pressure (TIP) and developed a regression model of TPUT expressed as a percentage of TIP ( K TP ) versus limb circumference: TPUT = 1.876 × [Extremity circumference (cm) −0.2399 ]. Kasem et al 19 found this formula was more effective in estimating the lowest effective TP in surgeries of the lower limbs than the estimating formula proposed by Liu et al 26 .…”

Section: Discussionmentioning

confidence: 88%

“…The estimation group provided comparable bloodless surgical fields with a relatively lower pressure. Kasem et al 19 used the method and found that good bloodless surgical fields could be achieved at a TP of 208 ± 12 mmHg. Kim et al 31 compared the low cuff pressures of SBP + 120 mmHg to higher ones of SBP + 150 mmHg and found no difference in the quality of the bloodless surgical field, safety outcomes, and tourniquet-related complications.…”

Section: Discussionmentioning

confidence: 99%

“…However, AOP measurement usually relies on specific tourniquet apparatus and the high costs limit wide application. Tuncali et al 17 reported an innovative formula for estimating AOP based on the tissue padding coefficient (K TP ) and SBP: AOP = ( SBP + 10 mmHg)/ K TP , which was shown to be simple, without requiring any special equipment 18 , 19 .…”

Section: Introductionmentioning

confidence: 99%

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An alternative method for personalized tourniquet pressure in total knee arthroplasty: a prospective randomized and controlled study

et al. 2022

Sci Rep

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Tourniquet use always carries potential risks, which can range from mild transient functional impairments of thigh pain, skin blisters to severe permanent dysfunction of limb paralysis, nerve injuries or compartment syndrome. The ideal method for minimizing intraoperative tourniquet pressure (TP) for reducing postoperative complications remains controversial. In this prospective, randomized and controlled study, we reinvestigated an estimation formula for TP based on thigh circumferences and systolic blood pressure (SBP) with two traditional methods for TP determination in total knee arthroplasty (TKA): SBP plus 100 mmHg and a fixed value of 300 mmHg. TP values and postoperative thigh pain scores were compared among three groups. The intraoperative TP value of the formula-calculated group was lower than that of the traditional groups (14.7 mmHg, P = 0.3475 and 94.7 mmHg, P < 0.0001, respectively), while no differences of hemostatic effect at the surgical fields and wound complications were detected among groups. The thigh pain scores at the tourniquet site decreased gradually over time and the estimation group had the lowest scores at each timepoint after surgery. Estimation method for TP was easy and rapid, without relying on specific equipment. It could provide a practical low TP and comparable hemostatic effect in TKA using an inflating tourniquet.

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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An alternative method for personalized tourniquet pressure in total knee arthroplasty: a prospective randomized and controlled study

et al. 2022

Sci Rep

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“…In another study, Tuncali et al ( 15 ) compared the LOP and AOP methods for setting tourniquet pressure in normotensive adult patients and found both methods were comparable. Kasem et al ( 21 ) concluded that the AOP method was more effective than the mathematical formula of Hong-yun Liu et al ( 22 ) in knee arthroscopy.…”

Section: Discussionmentioning

confidence: 99%

Minimal Inflation Tourniquet Pressure Using Induced Hypotension with Limb Occlusion Pressure Determination or Arterial Occlusion Pressure Estimation in Upper Limb Surgery: A Randomized Double-Blinded Comparative Study

et al. 2020

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Objectives This study compared the efficacy and safety of minimal tourniquet pressure using either determined limb occlusion pressure (LOP) or estimated arterial occlusion pressure (AOP) for elective upper limb surgeries. Methods Forty patients undergone elective upper limb surgery under general hypotensive anesthesia were randomized into groups A and B, where tourniquet pressure was calculated using AOP estimation for group A and LOP determination for group B. AOP, LOP, the time needed to estimate the AOP and determine the LOP and set the tourniquet inflation pressure, tourniquet inflation pressure, initial and maximal systolic blood pressure, heart rate, intraoperative fentanyl requirement, arm circumference, and tourniquet time were recorded. Tourniquet performance was assessed, and signs of tourniquet-related complications were noticed. Results Systolic arterial blood pressure was comparable between the groups. Less time was recorded for measuring AOP or LOP and set the minimal inflation pressure (in second) in group A than in group B (62 ± 2 for group A vs. 120 ± 3 for group B; P < 0.001). The estimated AOP in group A was significantly higher than the determined LOP in group B (118 ± 2 vs. 91 ± 2; P < 0.001). Tourniquet inflation pressures were not significantly different between the groups. Tourniquet performance was excellent or good in all patients in both groups. Conclusions Arterial occlusion pressure estimation or LOP determination methods to set the tourniquet inflation pressure with hypotensive anesthesia can provide effective minimal inflation pressure and satisfactory surgical field for upper extremity surgeries without tourniquet-related complications.

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Tourniquets, types and techniques in emergency prehospital care: A narrative review

Ronconi¹,

Moreira²,

Lima³

et al. 2023

Medical Engineering & Physics

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Comparison between two mathematical methods to estimate arterial occlusion pressure and tourniquet effectiveness in lower limb surgery: a prospective, randomized, double blind, comparative study

Cited by 4 publications

References 18 publications

An alternative method for personalized tourniquet pressure in total knee arthroplasty: a prospective randomized and controlled study

An alternative method for personalized tourniquet pressure in total knee arthroplasty: a prospective randomized and controlled study

Minimal Inflation Tourniquet Pressure Using Induced Hypotension with Limb Occlusion Pressure Determination or Arterial Occlusion Pressure Estimation in Upper Limb Surgery: A Randomized Double-Blinded Comparative Study

Tourniquets, types and techniques in emergency prehospital care: A narrative review

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