Department of Orthopaedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok, 10400, Thailand.
J Orthop Surg Res. 2023 Jul 28;18(1):539. doi: 10.1186/s13018-023-04000-3.
In minor hand surgery, tourniquet is typically inflated to 250 mmHg. The pressure may be too high and cause unnecessary adverse effects. Limb occlusion pressure plus safety margin or recommended tourniquet pressure (RTP), has been reported as optimal pressure to provide bloodless field in limb surgeries. This study aimed to compare the RTP with the standard tourniquet pressure of 250 mmHg in minor hand surgery.
A double-blinded randomized control trial was conducted from July to December 2019 and June 2020 to May 2021. Patients were randomly assigned into two groups: RTP and 250 mmHg with 3:1 ratio allocation. The outcomes were measurement of cuff pressure reduction, time to develop of tourniquet pain and discomfort, pain score, discomfort score, motionless and bloodless of operative field determined by the surgeon's satisfaction.
A total of 112 patients were included, 84 were in RTP and 28 were in 250 mmHg group. Mean of tourniquet pressure was significantly lower in the RTP group (228.3 ± 17.2 mmHg) (P < 0.001). Even though, time to develop pain was not significantly different, the RTP group reported significantly less pain and discomfort, according to the pain score (P = 0.02) and discomfort score (P = 0.017). The RTP group provided better motionless field, while both groups equally created a bloodless field.
The RTP significantly reduced tourniquet related pain and discomfort during minor hand surgeries. It provided better motionless operative field and adequate bloodless field. Therefore, the RTP should be considered as optimal tourniquet pressure for minor hand surgeries.
TCTR20210519001 (retrospectively registered).
I.
在手部小手术中，止血带通常充气至 250mmHg。但这种压力可能过高，导致不必要的不良反应。肢体闭塞压加安全裕度或推荐的止血带压力（RTP）已被报道为在肢体手术中提供无血手术野的最佳压力。本研究旨在比较 RTP 与手部小手术中标准的 250mmHg 止血带压力。
一项双盲随机对照试验于 2019 年 7 月至 12 月和 2020 年 6 月至 2021 年 5 月进行。患者随机分为两组：RTP 组和 250mmHg 组，分配比例为 3:1。结果测量止血带压力降低、疼痛和不适发展时间、疼痛评分、不适评分、手术野的静止和无血状态，由外科医生的满意度决定。
共纳入 112 例患者，其中 RTP 组 84 例，250mmHg 组 28 例。RTP 组的止血带压力明显较低（228.3±17.2mmHg）（P<0.001）。尽管如此，疼痛发展时间并无显著差异，但 RTP 组的疼痛和不适评分明显较低（P=0.02 和 P=0.017）。RTP 组提供了更好的静止手术野，而两组均能产生无血手术野。
RTP 显著减轻手部小手术中与止血带相关的疼痛和不适。它提供了更好的静止手术野和足够的无血手术野。因此，RTP 应被视为手部小手术的最佳止血带压力。
TCTR20210519001（回顾性注册）。
I。
