OBJECTIVE The purpose of the present study is to determine the performance of tourniquet use by the placement of the tourniquet's windlass on the extremity in four positions--medial, lateral, anterior, and posterior--to inform tourniquet instructors and develop best tourniquet practices. METHODS A HapMed™ Leg Tourniquet Trainer was used as a manikin to test the effectiveness of an emergency t...

BACKGROUND A pneumatic tourniquet is generally used to achieve a bloodless operation field in hand surgery. However, this has changed with tumescent solution-based wide-awake surgery. This study is a preliminary prospective case series study to elaborate the formula and indications of the tumescent technique in hand surgery without a tourniquet. METHODS Seven patients (age range, 4 months to ...

BACKGROUND Gabapentin, an oral non-opioid analgesic, has been used to decrease pain after a variety of surgical procedures. We hypothesized that premedication with gabapentin would minimize tourniquet-related pain in patients receiving IV regional anesthesia (IVRA). METHODS Patients undergoing elective hand surgery with IVRA were randomly assigned to one of two study groups using a double-bli...

BACKGROUND There is no clinical trial analyzing the best moment to infuse an antibiotic during knee arthroplasty performed during ischemia. We designed a single-center, randomized, double-blind, placebo-controlled trial to evaluate whether antibiotic therapy should be administered before tourniquet inflation or just before tourniquet deflation. MATERIAL AND METHODS Patients who underwent a pr...

Background Persistent postsurgical pain after total knee arthroplasty is a common problem and major reason for patient dissatisfaction. This secondary analysis aimed to investigate the effects of anesthesia (spinal vs. general) tourniquet use on persistent arthroplasty. Methods In this previously presented parallel, single-center, randomized trial, 404 patients scheduled were spinal versus gene...

OBJECTIVES To evaluate through the visual analog scale (VAS) the pain in patients undergoing total knee replacement (TKR) with different pressures of the pneumatic tourniquet. METHODS An observational, randomized, descriptive study on an analytical basis, with 60 patients who underwent TKR, divided into two groups, which were matched: a group where TKR was performed with tourniquet pressures ...

The wide awake approach to hand surgery means that the patient is unsedated for up to 95% of all hand surgery procedures. For the patient, the experience is reduced to the equivalent of a visit to the dentist where no preoperative tests are required, only lidocaine with epinephrine is injected, and where they get up and go directly home after the procedure.1 This is made possible by the recent ...

Studies in healthy volunteers suggested that the classical counterirritation phenomenon (i.e. pain inhibits pain effect) might depend on diffuse noxious inhibitory controls (DNIC), which modulate the spinal transmission of nociceptive signals. In the present study, we sought to determine whether similar mechanisms were at play in patients with different subtypes of neuropathic pain. Ten patient...

OBJECTIVE The goal of the study was to investigate the regional intravenous anesthesia procedure in knee arthroscopy and to evaluate the effects of adding ketamine over the anesthesia block charactery and tourniquet pain. MATERIAL/METHOD Forty American Society of Anesthesiologists (ASA) II patients who received knee arthroscopy were enrolled. After monitoring, a peripheral IV line was inserte...