Piyavunno Choompon, Mahaisavariya Banchong
Department of Orthopaedic Surgery and Rehabilitation, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2012 Sep;95 Suppl 9:S110-3.
The tourniquet pain during 30 minutes after the application of calf tourniquet and ankle tourniquet were assessed and compared in 63 healthy volunteers, 32 males and 31 females whose ages ranged from 21-36 (average, 24) years. The visual analogue pain score assessed at 0, 1, 3, 5, 10, 20, 30 minutes of adequate tourniquet pressure application and after removal of the tourniquet at 0, 5 and 30 minutes were recorded. The results revealed significant less visual analogue pain scores with the ankle tourniquet group (range, 0-4.4 mmHg) than the calf tourniquet group (range, 0-6.7 mmHg) at all time-points of evaluations and the tourniquet pain was also diminished faster in the ankle tourniquet group after the tourniquet was removed. It was also found a significant higher minimal tourniquet pressure required for the vascular occlusion distal to the tourniquet sites detected by a pulse oximeter in the ankle tourniquet group (mean, 310.8 +/- 40.8 mmHg) than the calf tourniquet group (mean, 272.5 +/- 36.9 mmHg, p = 0.024). The present study supports the use of ankle tourniquet to minimize tourniquet pain for foot surgery.
在63名年龄在21至36岁（平均24岁）的健康志愿者（32名男性和31名女性）中，对应用小腿止血带和脚踝止血带后30分钟内的止血带疼痛进行了评估和比较。记录了在适当施加止血带压力的0、1、3、5、10、20、30分钟以及在0、5和30分钟去除止血带后评估的视觉模拟疼痛评分。结果显示，在所有评估时间点，脚踝止血带组（范围为0 - 4.4 mmHg）的视觉模拟疼痛评分明显低于小腿止血带组（范围为0 - 6.7 mmHg），并且在去除止血带后，脚踝止血带组的止血带疼痛减轻得也更快。还发现，通过脉搏血氧仪检测，脚踝止血带组（平均为310.8 +/- 40.8 mmHg）止血带部位远端血管闭塞所需的最小止血带压力明显高于小腿止血带组（平均为272.5 +/- 36.9 mmHg，p = 0.024）。本研究支持使用脚踝止血带以尽量减少足部手术中的止血带疼痛。
