The Effect of Tourniquet Inflation on Neural Functions: A Volunteer Study

Jun, Hee Jeong; Choi, Yoon; Jung, Heon Seok; Kim, Tae Yop; Jung, Seong Yang; Leem, Joong Woo

Abstract

BACKGROUND: Tourniquet pain has important impacts an anesthesia. Tourniquet pain and accompanying cardiovascular changes are important factors that make patients in distress during anesthesia. As tourniquet pain may be modified by anesthesia, a study on the changes in the neural functions by tourniquet inflation in normal volunteers is important.
METHODS
Time-dependent changes in tourniquet pain, heart rate, phantom limb sensation, motor function, pain to pressure on upper extremity of 10 healthy and unpremedicated volunteers were measured. Each parameter were measured every 5 minutes starting from 10 minutes before inflation to 15 minutes after deflation of tourniquet. Tourniquet was deflated when the subject felt unbearable pain (score 100 with visual analog scale).
RESULTS
Subjects manifested time-dependent pain responses to tourniquet inflation, characterized by increase in VAS, systolic and diastolic blood pressure. Mean duration of tourniquet inflation was 36.4 minutes, volunteers experienced motor paralysis at 27.6 minutes and sensory loss at 33.1 minutes. Pain to pressure decreased over time in both arms. The degree of decrease was greater in the arm on which tourniquet was applied than that in the non-applied arm. Phantom limb sensation occurred in 3 subjects.
CONCLUSIONS
This study demonstrated dynamic changes in the neural functions during tourniquet inflation period. Tourniquet-induced pain and resultant hypertension occurred in all subjects. Appropriate anesthetic management is needed for the surgery using tourniquet.