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The minimum effective midthigh tourniquet pressure

H S Estersohn, H A Sourifman

The Journal of Foot Surgery

|January 1, 1982

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Establishing a minimum effective tourniquet pressure in lower extremity surgery helps prevent nerve damage. The study found 90-100 mm Hg above systolic arm pressure, averaging 210 mm Hg, to be the minimum effective pressure.

Area of Science:

Orthopedic Surgery
Surgical Hemostasis
Neurophysiology

Background:

Tourniquet use in lower extremity surgery is common for achieving a bloodless field.
Inadequate tourniquet pressure can lead to insufficient hemostasis, while excessive pressure risks nerve injury.
Determining the minimum effective tourniquet pressure is crucial for balancing surgical efficacy and patient safety.

Purpose of the Study:

To establish the minimum effective midthigh tourniquet pressure required for optimal hemostasis during lower extremity surgery.
To identify a pressure threshold that minimizes the risk of nerve compression and subsequent nerve damage.

Main Methods:

Investigated various tourniquet pressures applied at the midthigh level of the operated extremity.
Determined the lowest tourniquet pressure that successfully achieved adequate hematosis (bloodlessness).

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Main Results:

The minimum effective tourniquet pressure was established at 90-100 mm Hg above the preoperative systolic arm pressure.
This resulted in an average tourniquet pressure of 210 mm Hg for effective surgical hemostasis.

Conclusions:

A midthigh tourniquet pressure of 90-100 mm Hg above systolic arm pressure is effective for lower extremity surgery.
This pressure range aids in preventing nerve damage by avoiding excessive compression while ensuring adequate hemostasis.