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[Tourniquet pain: anatomic-physiological notes and clinical aspects]
F Ramaioli1, D De-Amici, P Ceriana
1Servizio di Anestesia e Rianimazione II, IRCCS Policlinico S. Matteo, Pavia.
Objectives:
The mechanism of tourniquet pain is quite complex. This paper, supported by the previous literature on this topic, tries to explain why the anaesthetic blockade of a limb, even when thechnically successful, not always prevents the occurrence of this pain.
Data Sources:
Papers published between 1990 and 1995, listed on Index Medicus, with pertinent references.
Study Selection:
Reports dealing with physiological basis of tourniquet pain.
Conclusions:
Tourniquet pain is nociceptive, generated not only by activation of peripheral nociceptors, but also by direct axonal stimulation of nervous trunks. Is is hardly to tolerated by patients since ischemia and mechanical compression induce an activation of C fibres, resistent to ischemia. A beta fibres are involved as well, due to the activation of low-threshold mechanoceptors.