Comparison of pain perceived when using pneumatic or silicone ring tourniquets for local anaesthetic procedures in the upper limb

Smith, Oliver J.; Heasley, Richard; Eastwood, G.; Royle, S. G.

doi:10.1177/1753193412449116

Cited by 5 publications

(4 citation statements)

References 24 publications

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“…Patients who have had previous procedures without WAHS have reported that they preferred surgery without a tourniquet. A recent paper (Smith et al, 2012) compared pain perceived from pneumatic and silicone ring tourniquets on the upper limb in 30 healthy volunteers. They concluded that the silicone ring tourniquet “would not be suitable for local anaesthetic procedures due to the severe pain experienced on application.” These volunteers experienced considerable pain with both pneumatic and silicone ring tourniquets, and in fact commented that they “would not feel comfortable on the operating table after such a painful experience.” A big advantage of the WAHS technique is the elimination of tourniquets and its associated pain, therefore reducing the overall discomfort of surgery.…”

Section: Discussionmentioning

confidence: 99%

Patients’ perspective of wide-awake hand surgery — 100 consecutive cases

Teo

Lam

Muthayya

et al. 2013

J Hand Surg Eur Vol

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The wide-awake hand surgery (WAHS) technique involves injecting lidocaine with adrenaline for hand surgical procedures that are done without the use of tourniquets, sedation, regional or general anaesthetic. This is a retrospective review of the first 100 consecutive patients who underwent operations using this technique at our centre. The operations included carpal and cubital tunnel decompression, trapeziectomy, tendon transfer, and tenolysis. A questionnaire adapted from Lalonde's previous work on wide-awake surgery was used to assess patients' experiences. Sixty-five percent of the patients responded to the postal questionnaire, the majority reporting a high satisfaction level. Ninety-one percent of responders reported that the operation was less painful or comparable with a procedure at the dentist; 86% would prefer to be wide-awake if they needed to have hand surgery again, and 90% stated they would recommend WAHS to a friend.

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Section: Discussionmentioning

confidence: 99%

Patients’ perspective of wide-awake hand surgery — 100 consecutive cases

Teo

Lam

Muthayya

et al. 2013

J Hand Surg Eur Vol

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“…The second showed that the conventional pneumatic tourniquet caused more pain after 5 minutes of application [12]. The third found greater pain with the Hemaclear 1 tourniquet [13]. Our results found no statistically significant difference between the two types of tourniquets in terms of the pain experienced by the patient.…”

Section: Discussionmentioning

confidence: 61%

Evaluation of a new tourniquet for hand surgery: Comparison of 76 carpal tunnel syndrome cases operated using a Hemaclear® Model-F tourniquet versus a pneumatic tourniquet

Pereira

Hendriks

Facca

et al. 2015

Chirurgie de la Main

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“…We acknowledge that there are several other commercially available tourniquet types and techniques that have not been examined. Despite this variability in local pressures, patients are usually pain free during procedures where digital tourniquets are applied under local anaesthetic, in comparison with upper arm tourniquets (Smith et al, 2012; Tanpowpong et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

Variability in local pressures under digital tourniquets

Middleton

Jenkins

Muir

et al. 2013

J Hand Surg Eur Vol

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The UK National Patient Safety Agency issued a rapid response report in 2009 following reports of complications related to digital tourniquet use and inadvertent retention. In their guidance, they recommend the use of CE marked digital tourniquets and advise against the use of surgical gloves. There are a number of different commercially available non-pneumatic digital tourniquets, but little clear data relating to their comparable physical properties, clinical efficacy or safety. The aim of this study was to investigate the variability of pressures exerted by non-pneumatic digital tourniquets. A Tekscan FlexiForce(®) force sensor was used to measure applied force and to calculate the surface pressures under: the Toe-niquet™; T-Ring™ and surgical glove 'roll down' tourniquets in finger models. The lowest mean pressures were produced by the larger glove sizes (size 8) (25 mmHg), while the highest pressures were produced by the Toe-niquet (1560 mmHg). There was a significant overall difference in pressures exerted under tourniquets when comparing tourniquet type (p<0.001) and finger size (p<0.001) with these techniques. It is difficult to anticipate and regulate pressures generated by non-pneumatic tourniquets. Safe limits for application time and surface pressures are difficult to define. Further work is required to model the pressure effects of commercially available digital tourniquets and to identify which are most effective but safe.

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Comparison of pain perceived when using pneumatic or silicone ring tourniquets for local anaesthetic procedures in the upper limb

Cited by 5 publications

References 24 publications

Patients’ perspective of wide-awake hand surgery — 100 consecutive cases

Patients’ perspective of wide-awake hand surgery — 100 consecutive cases

Evaluation of a new tourniquet for hand surgery: Comparison of 76 carpal tunnel syndrome cases operated using a Hemaclear® Model-F tourniquet versus a pneumatic tourniquet

Variability in local pressures under digital tourniquets

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