A quantitative method of determining the pneumatic ankle tourniquet setting

Pneumatic ankle tourniquets are currently used in podiatry for maintaining hemostasis during foot surgery. The literature is limited concerning the safest pressure to use with this device. This study was undertaken to develop a simple and reliable method of deriving a proper pressure setting that would be safe and efficacious. Using a Doppler stethoscope, the minimum effective tourniquet pressure was established on 54 limbs from 35 patients undergoing foot surgery at our institution. The average pressure needed to obtain a "bloodless field" was 218.6 +/- 34.6 mm. Hg. However, in the younger, normotensive patients the average pressure utilized was 203.9 +/- 22.3 mm. Hg. The lower pressures used were felt to be safer and better tolerated by the patients. The authors concluded that the minimum effective pressure should be determined for each patient preoperatively and the routine use of a maximum safe pressure of 250 mm. Hg should be discouraged.