Experimental and clinical study of safe prolongation of tourniquet time by hypothermia of an upper limb
Seki, T.
Nihon Seikeigeka Gakkai Zasshi 54(8): 721-737
1980
ISSN/ISBN: 0021-5325 PMID: 7205039 Document Number: 162123
A practical method by which the tourniquet can be safely applied for > 2 h, i.e., the safe limit in the conventional method, was established. Adult mongrel dogs (35) were used including a control group. One hour immersion of a hind limb in ice water lowers the temperature of leg muscles from .apprx. 38.degree. C to 16-18.degree. C. Maintenance of tourniquet exsanguination of the cooled hind limb for 5 h elevates the muscle temperature several degrees, but it remains lower than in the control group. Edema and limping appeared after release of the tourniquet and subsided faster in the cooled group than in the control group. In 12 cases cooling of an upper limb after general anesthesia or nerve block with ice bags for 30 min lowered the temperature of the forearm muscles from 30.degree.-35.degree. C to 16.degree.-25.degree. C. Tourniquet applied thereafter at the upper arm was kept inflated maximally for 4 h and 7 min. An average of 3 h and 30 min did not cause any serious side effects but only temporary dysesthesia at the finger tips in 2 cases and a Tinel's sign at the site where tourniquet was applied in 1 case. Tourniquet time could be safely prolonged for 4 h; how far it can be safely prolonged needs clarification.