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Comparison between two mathematical methods to estimate arterial occlusion pressure and tourniquet effectiveness in lower limb surgery: a prospective, randomized, double blind, comparative study

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Abstract

The effectiveness of two different methods for calculating the arterial occlusion pressure (AOP) to set tourniquet inflation pressures were assessed in patients underwent knee arthroscopy. Eighty patients were included in this study. Tourniquet inflation pressure was set by adding 20 mmHg of safety margin above the AOP value which was calculated by either the Tuncali et al. formula or Hong-yun Liu et al. formula. Primary outcome measures were the initial and maximum SBP, initial and maximum tourniquet inflation pressure, the secondary outcomes were the surgeon rating of the bloodlessness of the surgical field and tourniquet associated complications. There was significant difference in the initial tourniquet pressure (mmHg); it was 208 ± 12 and 262 ± 18 for group (A) and (B) respectively; also there was significant difference in the maximum tourniquet pressure (mmHg), it was 229 ± 14 and 283 ± 19 for group (A) and (B) respectively. There was no significant difference in the initial SBP-to- tourniquet inflation time, the initial SBP or the maximum SBP between the groups. Also, there was no significant difference in surgeon rating of the bloodlessness of the surgical field, at the start, middle and end of surgery. Hong-yun Liu et al. mathematical formula was found to be less effective than Tuncali et al. formula to estimate the least effective tourniquet pressure in lower limb surgery and we might consider it invalid to be used in the lower limb.

Clinical trials registration number: NCT03706859 (Clinicaltrials.gov) and registration date: January, 2019. https://clinicaltrials.gov/ct2/show/NCT03706859

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Data availability

The datasets generated during and/or analysed during the current study are not publicly available due to confidentiality of FM-BSU files but are available from the corresponding author on reasonable request.

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Funding

The current study was funded by FM-BSU as regards the drug, equipments and data.

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Authors and Affiliations

  1. Anesthesia Department, Faculty of Medicine, Beni Suef University, Street 10, Pyramids gardens, Giza, Egypt

    Samaa A. Kasem & Tarek Al Menesy

  2. Anesthesia Department, Faculty of Medicine, Cairo University, Giza, Egypt

    Ahmed A. Badawy, Ashraf Abd Elmawgoud & Ghada Adel

  3. Faculty of Medicine, Cairo University, Giza, Egypt

    Yasmin A. Badawy

Authors
  1. Samaa A. Kasem
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  2. Tarek Al Menesy
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  3. Ahmed A. Badawy
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  4. Ashraf Abd Elmawgoud
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  5. Ghada Adel
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  6. Yasmin A. Badawy
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Contributions

SK and TM put the design and the protocol and shared in the clinical part, AAB and AM shared in writing the manuscript and carried out the statistical data analysis, GA shared in writing the manuscript and revising the data analysis and YAB shared in collecting the background resources and writing the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Samaa A. Kasem.

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The authors declare that they have no competing interests.

Ethics approval

The study protocol was approved by the ethical committee of Faculty of medicine, Beni Suef University (FM-BSU), Egypt (approval number 005/2018).

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Informed consent was obtained to participate this study from the patients.

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Kasem, S.A., Al Menesy, T., Badawy, A.A. et al. Comparison between two mathematical methods to estimate arterial occlusion pressure and tourniquet effectiveness in lower limb surgery: a prospective, randomized, double blind, comparative study. J Clin Monit Comput 34, 675–681 (2020). https://doi.org/10.1007/s10877-019-00366-0

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  • DOI: https://doi.org/10.1007/s10877-019-00366-0

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