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Continuing Education in Anaesthesia, Critical Care & Pain Advance Access originally published online on March 4, 2009
Continuing Education in Anaesthesia, Critical Care & Pain 2009 9(2):56-60; doi:10.1093/bjaceaccp/mkp002
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© The Author [2009]. Published by Oxford University Press on behalf of The Board of Directors of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournal.org

Arterial tourniquets

John L. Deloughry, FRCA
Specialist Registrar
Department of Anaesthesia
Norfolk and Norwich University Hospital
Colney Lane
Norwich NR4 7UY
UK

Richard Griffiths, MD FRCA
Consultant Anaesthetist
Department of Anaesthesia
Peterborough and Stamford Hospitals
NHS Foundation Trust
Thorpe Road
Peterborough PE3 6DA
UK
Tel: +44 1733 874327 Fax: +44 1733 875684 E-mail: richard@wothorpe.com

The first 150 words of the full text of this article appear below.


Key points

Complications of tourniquet use are rare, but can be catastrophic.
Local effects of arterial tourniquets result from tissue compression beneath the cuff and ischaemia distal to it.
Tissue compression predominantly affects nerve tissue, whereas muscle is more susceptible to ischaemia.
Widespread systemic effects of arterial tourniquets usually result from cuff inflation and deflation.
Limits for inflation pressures and times should be tailored to individual patients.

 

A tourniquet is a device which is used to control the flow of blood to and/or from an extremity. The word tourniquet itself derives from the French verb tourner (to turn) and was first used by the eighteenth-century French surgeon Louis Petit describing the screw-like device he strapped to the thighs of patients undergoing leg amputations, to reduce blood loss. This article focuses on the use of arterial tourniquets. The arterial tourniquet is usually a pneumatic device consisting of an inflatable cuff connected . . . [Full Text of this Article]


   Physiological effects of tourniquet application
 
Local effects

Muscle

Nerve

Systemic effects

Cardiovascular effects

Respiratory effects

Central nervous system effects

Haematological effects

Temperature effects

Metabolic effects


   Complications associated with the use of arterial tourniquets
 
Nerve injury

Muscle injury

Skin injury

Vascular injury

Intraoperative bleeding


   Tourniquet pain
 

   Tourniquet-induced hypertension
 

   Tourniquet pressures and safe inflation times
 
Pressures

Duration


   Conclusions
 

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