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Comparison between Fixed Tourniquet Inflation Pressure and Limb Occlusion Pressure in Children Undergoing Corrective
Obinna C Imo1, Olatunji O Babalola2, Emeka B Izuagba2
1Department of Orthopaedics and Trauma, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra, Nigeria.
Background:
A tourniquet is commonly used to achieve a clear operative field during corrective osteotomies for Blount's disease in children. Excessive tourniquet pressures may, however, lead to complications that may threaten the child's limb, causing avoidable morbidity. Determining the minimum effective cuff pressure required to achieve a bloodless field without causing any harm to the child's limb becomes essential to good surgical practice.
Objectives:
To compare the effectiveness of and the complications arising from the tourniquet between fixed inflation pressure (FIP) and pressure determined by limb occlusion pressure (LOP) in children undergoing corrective osteotomy for Blount's disease.
Materials And Methods:
Fifty lower limbs of 50 children aged 5-17 years who were undergoing corrective osteotomy for Blount's disease were randomised into two groups (A and B) of 25 each. Group A is the LOP, whereas Group B is the FIP group. The tourniquet pressure, quality of the clear operative field, local tourniquet complications of pain, skin damage and nerve palsy were compared between the groups. Tourniquet pressure, effectiveness, complications, corrective osteotomy and Blount's disease between the groups. Data were analysed using IBM SPSS statistic version 23.
Results:
The mean age of the population was 7.2 years. There was a significant mean decrease of pressure of 82 mmHg in Group A compared to Group B. Both groups had similar quality of the bloodless field; however, there were significantly less complications in Group A.
Conclusions:
LOP method performs better than the fixed pressure method. It achieves a comparable bloodless field while having a better safety profile.
