The Journal of hand surgery, European volume
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J Hand Surg Eur Vol · Jun 1985
Tourniquet pressure: the effect of limb circumference and systolic blood pressure.
Complications attributable to direct pressure may result from the use of pneumatic tourniquets during surgical procedures. Traditional estimates have determined the pressures employed rather than the minimal pressure necessary to produce a bloodless field. ⋯ From these results two equations were derived, one for each of the upper and lower limbs, which give the minimum tourniquet pressures to produce bloodless fields. In an average sized, normotensive patient, 200mm Hg was found to be adequate for the upper limb and 250mm Hg for the lower limb.
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J Hand Surg Eur Vol · Jun 1985
Effects of regional intravenous guanethidine block in posttraumatic cold intolerance in hand amputees.
In twenty-four patients with intolerance to cold after partial or complete finger amputations, lower skin temperature together with cold and vibration allodynia (allodynia = pain due to a non-noxious stimulus to neural skin) were found in the cold intolerant area compared with the corresponding area in the uninjured hand. When treated with regional intravenous guanethidine block nine patients became free from symptoms for up to twelve weeks, which is longer than would be expected from the duration of the known pharmacological effects of guanethidine. The patients had several features in common with reflex sympathetic dystrophies, and we suggest that neurogenic rather than vascular disturbances are mainly involved in the post-traumatic cold intolerance syndrome.