title: Sensory changes with prolonged double-cuff tourniquet time in hand surgery.
abstract: This study evaluates the sensory changes that occur in the operated hand after the use of the double-cuff tourniquet technique for up to 4 hours. Thirty patients whose hand operations lasted more than 2 hours were evaluated. Tourniquet time ranged between 2 hours and 4 hours, 17 minutes. Light touch, von Frey's aesthesiometry, vibratory sensation, and two-point discrimination were examined. Subjective overall sensation and postoperative edema were also assessed. Patients were evaluated the evening before operation, on the second postoperative day, and at every out-patient follow-up visit, until all examined parameters returned to normal. Of the patients 73% demonstrated clinically normal sensibility test results within 23 days after operation. In 80% of all patients, subjective sensibility of the operated hand was equal to the nonoperated hand within 1 week of operation. Ultimately, all patients (96%) but one, demonstrated normal sensibility test results and normal subjective sensibility. Postoperative edema developed in 53% of the patients; it subsided in less than 4 weeks. The double-cuff technique can prolong tourniquet time safely for up to 4 hours.
authors.affiliation: Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston.
authors.forename: U Y
authors.initials: UY
authors.lastname: Dreyfuss
authors.forename: R J
authors.initials: RJ
authors.lastname: Smith
mesh_terms: D004487:Edema / Q000209:etiology; D006225:Hand / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012677:Sensation; D013997:Time Factors; D014111:Tourniquets