Untitled

Abstract

Specific objective: A study was undertaken to evaluate the superiority of Lowest occlusion pressure method of using the pneumatic tourniquet verus the other routine ways of usage of Pneumatic Tourniquets in Orthopaedics surgery which include the Fixed and Systolic Blood Pressure variants. Materials and methods:This study included 120 patients of both upper and lower limbs trauma. These patients were randomly included any of the three categories of study after fullfilling the inclusion and exclusion criteria. Three modalities of application of toruniquet were included in this study. They were Fixed, Systolic Blood pressure (SBP) and Lowest Occlusion Pressure methods (LOP). Each category included 40 patients and the results were analysed according to final outcome using Ishii et al. grading, VAS Score criteria. Results: In our study 120 cases managed by LOP had better results compared to fixed variant and Systolic BP variant in terms of less pressure needed to keep tourniquet, good operative field, pain score (VAS) at tourniquet application region and skin injury (reddening). But no complications like compartment syndrome, deep vein disorder, paresis, nerve injury has occurred before and after surgery Conclusion: LOP method of using the pneuamtic tourniquet is superior to the other methods of using Tourniquet in terms of less pressure needed for elevating tourniquet, Good operative (blood less) field, no skin abrasions.Keywords: Pneumatic tourniquet, lowest occlusion pressure, systolic blood pressure, orthopaedic surgery IntroductionThe use of pneumatic tourniquet in orthopaedic surgery has been widely debated over the years. A pneumatic tourniquet is a device that allows the surgeon to have a bloodless field for the duration of the surgery [1,2] . This allows the surgeon to reduce the surgical time since all the anatomic structures are clearly visualised. The reason for debate is due to the postoperative problems experienced by the patient. Tourniquet site pain, tourniquet palsy, chemical burns at the site of tourniquet are common patient related problems consequent to using a tourniquet [3][4][5] . Great efforts have been made to identify the minimum pressure to which the tourniquet should be inflated so as to avoid the above mentioned problems. [6] In this study, we aim to use the pneumatic tourniquet by inflating it to the lowest occlusion pressure (LOP) and study its effects in terms of quality of bloodless field and post-operative complications. The results were compared with the standard techniques of using a tourniquet described already in the literature.