title: Arm versus forearm tourniquet for carpal tunnel decompression - Which is better? A randomized controlled trial.
abstract: Tourniquet pain is a common source of complaint for patients undergoing carpal tunnel decompression and practice varies as to the tourniquet position used. There is little evidence to suggest benefit of one position over another. Our aim was to compare patient and surgeon experience of forearm and arm tourniquets. Following a power calculation, 100 patients undergoing open carpal tunnel decompression under local anaesthetic were randomized to either an arm or a forearm tourniquet. Measurements of blood pressure, heart rate and pain were taken at 2.5 min intervals. The operating surgeon also provided a visual analogue scale rating for the extent of bloodless field achieved and for any obstruction caused by the tourniquet. There was no statistically significant inter-group difference in patient pain or physiological response, tourniquet time, bloodless field or length of procedure. The degree of obstruction caused by the tourniquet was significantly higher in the forearm group.
  
  
  METHODS
  I. Prospective Randomized Controlled Trial.
authors.affiliation: Department of Orthopaedics and Trauma, Ninewells Hospital, Dundee, UK gerard.cousins1@nhs.net.
authors.forename: G R
authors.initials: GR
authors.lastname: Cousins
authors.affiliation: Department of Orthopaedics and Trauma, Ninewells Hospital, Dundee, UK.
authors.forename: S L
authors.initials: SL
authors.lastname: Gill
authors.affiliation: Department of Orthopaedics and Trauma, Ninewells Hospital, Dundee, UK.
authors.forename: C G
authors.initials: CG
authors.lastname: Tinning
authors.affiliation: Department of Orthopaedics and Trauma, Ninewells Hospital, Dundee, UK.
authors.forename: S M
authors.initials: SM
authors.lastname: Johnson
authors.affiliation: Department of Orthopaedics and Trauma, Ninewells Hospital, Dundee, UK.
authors.forename: P K
authors.initials: PK
authors.lastname: Rickhuss
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local; D001132:Arm; D001794:Blood Pressure; D002349:Carpal Tunnel Syndrome / Q000601:surgery*; D019299:Decompression, Surgical; D005260:Female; D005542:Forearm; D006339:Heart Rate; D006801:Humans; D008012:Lidocaine; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014111:Tourniquets; D064232:Visual Analog Scale
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine
keywords: Carpal tunnel decompression; forearm tourniquet; tourniquet; tourniquet position