Tourniquet pain: calf versus ankle tourniquet

The tourniquet pain during 30 minutes after the application of calf tourniquet and ankle tourniquet were assessed and compared in 63 healthy volunteers, 32 males and 31 females whose ages ranged from 21-36 (average, 24) years. The visual analogue pain score assessed at 0, 1, 3, 5, 10, 20, 30 minutes of adequate tourniquet pressure application and after removal of the tourniquet at 0, 5 and 30 minutes were recorded. The results revealed significant less visual analogue pain scores with the ankle tourniquet group (range, 0-4.4 mmHg) than the calf tourniquet group (range, 0-6.7 mmHg) at all time-points of evaluations and the tourniquet pain was also diminished faster in the ankle tourniquet group after the tourniquet was removed. It was also found a significant higher minimal tourniquet pressure required for the vascular occlusion distal to the tourniquet sites detected by a pulse oximeter in the ankle tourniquet group (mean, 310.8 +/- 40.8 mmHg) than the calf tourniquet group (mean, 272.5 +/- 36.9 mmHg, p = 0.024). The present study supports the use of ankle tourniquet to minimize tourniquet pain for foot surgery.