Background and Objectives: Melatonin and Ketorolac delay and minimize intraoperative tourniquet pain when used as premedication to lidocaine-based intravenous regional anesthesia (IVRA). It is unclear if Melatonin is more efficacious compared with Ketorolac. This study compared intraoperative tourniquet pain, postoperative analgesia, and side effects of using Melatonin vs. Ketorolac during outp...

BACKGROUND To assess the effects of tourniquet use in arthroscopic anterior cruciate ligament (ACL) reconstruction surgery. METHODS We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) that compared surgical outcomes following tourniquet use against non-tourniquet use during ACL reconstruction surgery. We searched the Cochrane Central Register of Controlle...

The 232 patients had 428 tourniquets applied on 309 injured limbs. The most effective tourniquets were the Emergency Medical Tourniquet (92%) and the Combat Application Tourniquet (79%). Four patients (1.7%) sustained transient nerve palsy at the level of the tourniquet, whereas six had palsies at the wound level. No association was seen between tourniquet time and morbidity. There was no appar...

Tourniquet has long been used in TKA (Total Knee Arthroplasty) as the other orthopedic procedures for decreasing operation time and blood loss, providing better visualization of anatomic structures. While having much more advantages, these devices have a potential of serious complications, so they must be used with adequate knowledge and attention. Paralysis, compression neuropathy, compartment...

BACKGROUND The effects of cuff shape, timing of tourniquet application, and automated systems using limb occlusion pressure (LOP) have been reported to minimize the appropriate tourniquet pressure. However, studies on the raw material of the cuff itself to reduce the complications related to the tourniquet have been very rarely reported. The purpose of this study is to report the efficacy and s...

We studied perioperative pain and postoperative neurological changes after surgery for hallux valgus in 50 patients operated on under local ankle block. Patients were randomised to have the pneumatic tourniquet either at calf level or just above the ankle. The cuffs were inflated to 100 mmHg above systolic blood pressure. One patient was withdrawn from the study after randomisation. Areas of pa...

BACKGROUND Local anesthesia is widely used for open carpal tunnel release. However, injection of local anesthesia as described by Altissimi and Mancini (1988) can interfere with endoscopic carpal tunnel release, by increasing the bulk of synovial layers and consequently result in worsening of the view. PURPOSE The purpose of this study was to evaluate the safety, efficacy using modified techn...

This study examines the relationship between pneumatic tourniquet cuff size, occlusion pressure and the resulting pain. Two tourniquet cuff widths were used, a wide (14 cm) and a narrow cuff (7 cm). Twenty volunteers were divided into two groups for tourniquet application: a pressure group in which the tourniquet was inflated to a pressure equal to the systolic pressure + 100 mmHg, and a satura...

Tissue damage during surgery induces coagulation factors and activates platelets. Surgical pain may provoke release of catecholamines, leading to hypercoagulability. We have investigated the effect of surgical pain on blood coagulability and fibrinolysis in orthopaedic operations using tourniquets in 22 patients undergoing total knee replacement. Patients were allocated to one of two groups to ...

BACKGROUND Surgical treatment of osteoarthritis with total knee arthroplasty (TKA) usually takes place in a complete bloodless field using a tourniquet. However, doing the surgery without a tourniquet may reduce muscle damage, post-surgery pain and led to improved functional rehabilitation and mobilization. METHODS/DESIGN A prospective, blinded, parallel-group, controlled superiority trial, w...