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[Pneumatic tourniquets in orthopedics]

J P Estebe1, Y Mallédant

  • 1Département d'anesthésie et de réanimation chirurgicale, CHRU de Rennes, France.

Annales Francaises D'Anesthesie Et De Reanimation
|January 1, 1996
PubMed
Summary

Pneumatic tourniquets, used for bloodless surgery, pose risks like nerve damage and sepsis. Minimizing tourniquet time and using local hypothermia can reduce adverse effects.

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Area of Science:

  • Orthopedics
  • Anesthesiology
  • Vascular Surgery

Context:

  • Pneumatic tourniquets are widely used in surgery to achieve a bloodless field.
  • Their application, however, is associated with a range of potential complications affecting limb tissues and systemic physiology.

Purpose:

  • To comprehensively review the adverse effects of pneumatic tourniquets.
  • To discuss the mechanisms underlying these complications and explore strategies for mitigation.

Summary:

  • Tourniquet use causes limb ischemia and reperfusion injury due to mechanical compression and stretching, leading to sensory-motor deficits.
  • Systemic risks include increased sepsis, pulmonary thromboembolism, and hemodynamic instability.
  • Regional anesthesia is preferred to manage tourniquet hypertension, while limiting application time and using hypothermia can minimize harm.

Impact:

  • Highlights the significant risks associated with pneumatic tourniquets, emphasizing the need for careful application.
  • Provides evidence-based recommendations for minimizing tourniquet-related morbidity.
  • Informs surgical and anesthetic practices to improve patient safety during procedures requiring exsanguination.

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