title: Upper Extremity Nerve Function and Pain in Human Volunteers with Narrow versus Wide Tourniquets.
abstract: Nerve injury is a serious potential complication associated with clinical use of tourniquets during surgery. A novel narrow, single-use silicon ring tourniquet has been introduced, which may cause less nerve compression and provide a larger field of surgical exposure than standard wide tourniquets. We investigated both types of tourniquets in the non-dominant proximal upper arm of 15 healthy human volunteers. Pain and neurological effects were assessed during 15 minute trials with each tourniquet applied 1 week apart without anesthesia according to the manufacturers' recommendations. Median nerve function was studied using the pressure-specified sensory device, an instrumented two-point discriminator, and pain was assessed by two validated instruments. Skin sores, redness, nerve damage, or neurological complications did not occur in either group. Subjects reported more pain with the narrow tourniquet; however, measurable effect on median nerve function was the same in both groups. Tourniquet application with the narrow device was more efficient, the device was easier to use, and larger surgical field exposure was obtained. We conclude that the sensory deficit with the use of narrow tourniquets is not greater than that observed with pneumatic/wide tourniquets.
authors.affiliation: Department of Trauma Surgery, Medical University of Vienna, Wien, Austria.
authors.forename: Florian
authors.initials: F
authors.lastname: Kovar
authors.affiliation: Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland; Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Medical Center/University Hospital Brooklyn, Brooklyn, NY.
authors.forename: Julio J
authors.initials: JJ
authors.lastname: Jauregui
authors.affiliation: Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD.
authors.forename: Stacy C
authors.initials: SC
authors.lastname: Specht
authors.affiliation: Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD.
authors.forename: Erin
authors.initials: E
authors.lastname: Baker
authors.affiliation: Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland.
authors.forename: Anil
authors.initials: A
authors.lastname: Bhave
authors.affiliation: Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD.
authors.forename: John E
authors.initials: JE
authors.lastname: Herzenberg
mesh_terms: D001132:Arm / Q000503:physiopathology*; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000503:physiopathology*; D010146:Pain / Q000209:etiology*; D010147:Pain Measurement; D014111:Tourniquets