• Bahattin Tuncali, Ayse Karci, Binnur Erdalkiran Tuncali, Omur Mavioglu, Mustafa Ozkan, Abdul Kadir Bacakoglu, Hakan Baydur, Ahmet Ekin, and Zahide Elar.
• Department of Anesthesiology and Reanimation, Dokuz Eylul University, Izmir, Turkey. bahattin.tuncali@deu.net.tr
• Anesth. Analg. 2006 Jun 1;102(6):1752-7.

AbstractTo reduce pressure-related injuries resulting from pneumatic tourniquet use, the lowest possible inflation pressure is recommended. Arterial occlusion pressure (AOP) is a measure of the cuff pressure required to maintain a bloodless surgical field. However, its determination method is time consuming, requires operator skill, and is therefore seldom used in current practice. An AOP estimation can be made by knowing the pressure transmitted to the underlying soft tissues. We measured upper and lower extremity tissue pressures under the tourniquet cuff at 100, 200, and 300 mm Hg of tourniquet inflation pressures in 30 anesthetized living adult patients. All patients received general anesthesia with neuromuscular relaxation. A Stryker intra-compartmental pressure monitor was used to measure tissue pressures under the tourniquet cuff. In all patients, the soft tissue pressures were consistently lower than the applied tourniquet inflation pressures. Our results revealed tissue padding coefficients for extremities 20 to 75 cm in circumferences. An estimation method of AOP was developed [AOP = (systolic blood pressure + 10)/Tissue padding coefficient]. The new AOP estimation method may be a simple, rapid, and clinically practical alternative to the AOP determination method.

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