- Commonly used in surgical practice
- When properly used they provide excellent haemostasis
- When incorrectly used they are dangerous
- Cuff failure can be disastrous with rapid systemic absorption of drugs (e.g. local anaesthetics)
Safeguards
- Ensure correct placement and connection
- Use adequate padding
- Exsanguinate limb before inflation
- Use minimal pressure - usually 100 mmHg above systolic blood pressure
- Use for minimal duration - no longer than 90 minutes
- Avoid multiple inflations or deflations
- Be aware of relative contraindications to use
- Previous DVT or PE
- Arterial disease
- Vasculitic disorders
- Sickle cell anaemia
Complications
- Nerve injury
- Vascular injury
- Postoperative embolic events
- Post-tourniquet syndrome
- Myoglobinuria
- Increased blood viscosity
- Increased postoperative pain
- Tourniquet burns
Bibliography
Eyers P, Ashley S, Scott
D J. Tourniquets in arterial bypass surgery. Eur J Endovasc Surg 2000; 20:
113-117.
Wakai A, Winter D C, Street J T, Redmond P H. Pneumatic tourniquets in extremity
surgery. J Am Acad Orthop Surg 2001; 9: 345-351. |