title: Clinical utilization of arterial occlusion pressure estimation method in lower limb surgery: effectiveness of tourniquet pressures.
abstract: OBJECTIVE
  The effectiveness of the arterial occlusion pressure (AOP) estimation method to set tourniquet inflation pressures was assessed in patients undergoing lower limb surgery.
  
  
  METHODS
  One hundred ninety-eight operations were performed in 224 lower extremities of 193 patients. Tourniquet inflation pressures were set using the AOP estimation formula and adding 20 mmHg of safety margin to AOP value. Primary outcome measures were the amount of tourniquet pressure and its effectiveness. The quality of the surgical field and complications were assessed by the surgical team in a blinded fashion. Secondary measures included the time required to set the tourniquet pressure and complications.
  
  
  RESULTS
  The initial and maximal tourniquet pressures used were 168.4±14.5 and 173.3±15.6 mmHg, respectively. The performance of the tourniquets was assessed as "excellent" and "good" in all stages of the procedure in 97.76% of cases. The time required to measure AOP and set the tourniquet cuff pressure was 19.0±2.6 sec. No complications occurred during or after surgery until discharge.
  
  
  CONCLUSIONS
  Clinical utilization of the AOP estimation formula is a practical and effective way of setting tourniquet pressures for lower limb surgery. Its usage allows achievement of a bloodless field with inflation pressures lower than those previously recommended in the literature for lower limb tourniquets.
authors.affiliation: Başkent University Zübeyde Hanım Practice and Research Center, Department of Anesthesiology and Reanimation, İzmir, Turkey. tuncali.bahattin@gmail.com.
authors.forename: Bahattin
authors.initials: B
authors.lastname: Tuncalı
authors.affiliation: Başkent University Zübeyde Hanım Practice and Research Center, Department of Orthopedics and Traumatology, İzmir, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Boya
authors.affiliation: Başkent University Faculty of Medicine, Department of Anesthesiology and Reanimation, Ankara, Turkey.
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Kayhan
authors.affiliation: Başkent University Zübeyde Hanım Practice and Research Center, Department of Orthopedics and Traumatology, İzmir, Turkey.
authors.forename: Şükrü
authors.initials: Ş
authors.lastname: Araç
authors.affiliation: Başkent University Zübeyde Hanım Practice and Research Center, Department of Orthopedics and Traumatology, İzmir, Turkey.
authors.forename: M Ali Kolay
authors.initials: MA
authors.lastname: Çamurdan
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000592:standards* / Q000706:statistics & numerical data*; D011312:Pressure; D014111:Tourniquets; D014421:Turkey