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Limb occlusion pressure as a tool to optimize the tourniquet pressure in total knee arthroplasty without compromising the creation of a bloodless surgical field

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Original Article

Author Details : Thirumalesh K Reddy*, Somanna Malchira

Volume : 10, Issue : 4 , Year : 2024

Article Page : 363-366

https://doi.org/10.18231/j.ijos.2024.059

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Abstract

Introduction : Pneumatic tourniquet is utilized in orthopedic surgery to create a bloodless field. Limb Occlusion Pressure (LOP) is the minimum pressure required at a specific time and location to halt arterial blood flow distal to the cuff.
Aim and Objective : The purpose of this study is calculation of the minimum possible tourniquet pressure using LOP to significantly reduce tourniquet pressure in Total knee arthroplasty surgery without compromising the creation of a bloodless surgical field.
Materials and Methods : This study included 200 patients who underwent primary total knee arthroplasty. Tourniquet pressure was set based on Limb occlusion pressure measured just before the surgery. After the surgery, surgeon was asked to rate the quality of the bloodless field on a visual analog scale, and look for post-operative complications like, tourniquet site pain, injury to skin, redness, blisters, flaring, neurological symptoms. tourniquet palsy and chemical burns.
Results: The average LOP was 163.65mmHg and average tourniquet pressure was 221.15mmHg. The minimum tourniquet pressure we used was 140mmHg. The quality of bloodless field was excellent in 88% patients. 6 patients (3%) had redness at the skin and 5 patient had tourniquet site pain. None of the patients had chemical burns, injury to skin, blisters or tourniquet palsy.
Conclusion : This new tourniquet technique based on Limb occlusion pressure (LOP), is an effective device for maintaining a bloodless surgical field in orthopedic limb surgery. By reducing tourniquet pressure, this method lowers the frequency and severity of pressure-related complications. The LOP estimation method is simple, quick, and effective, making it feasible for broader clinical use. It ensures safer, personalized cuff pressures for tourniquet applications in limb surgery.
Keywords : Limb occlusion pressure (LOP), Lowest occlusion pressure, Pneumatic tourniquet, Total knee arthroplasty(TKA), Total knee replacement, Tourniquet complications, Bloodless surgical field

How to cite : Reddy T K, Malchira S, Limb occlusion pressure as a tool to optimize the tourniquet pressure in total knee arthroplasty without compromising the creation of a bloodless surgical field. Indian J Orthop Surg 2024;10(4 ):363-366

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