Pathophysiologic effects distal to a tourniquet in the dog

Intramuscular tissue pO2, pCO2, and pH were monitored distal to a pneumatic tourniquet in a dog hindleg preparation. A severe state of tissue hypoxia, hypercarbia, and acidosis was quantitated. The recovery time for tissue gases following release increased with increasing tourniquet time. Elevated c.p.k. and lactic acid values were noted at 2 hours of ischemia, reflecting the muscle changes at that time. Histologic sections revealed early signs of degeneration by 1 hour which progressively increased with increased tourniquet ischemia. On the basis of this study, we conclude that ischemia should not exceed 1 to 1 1/2 hours if significant pathophysiologic tissue changes are to be avoided. If longer time is required, intermittent release of the tourniquet for 10 minutes at the end of each hour of inflation will avoid complications.