BACKGROUND AND AIMS: The use of a tourniquet during surgery is associated with a risk of neurological disorders. We compared whether a new tourniquet system using low pressure (250 mmHg) is safer than a standard tourniquet system using higher inflation pressure (350 mmHg). MATERIALS AND METHODS:Thirty-one patients (ASA I-II), ages 16-48 years, were studied with ENMG preoperatively and 3 weeks postoperatively following arthroscopic anterior cruciate ligament reconstruction. Tourniquet times varied between 30 and 146 min. RESULTS:Postoperative slowing of motor and sensory conduction was observed, as well as an increase of the minimum peroneal F-response and tibial H-reflex latencies. The sensory amplitude of the sural nerve decreased. Vastus medialis of the quadriceps femoris muscle showed a reduced interference pattern in ENMG in maximal voluntary effort postoperatively. No differences were found in measured results between the low and high pressure tourniquet systems. CONCLUSIONS: Slight postoperative ENMG alterations were demonstrated but the use of both tourniquet systems is safe within the limit of tourniquet times of less than 2 h.
RCT Entities:
BACKGROUND AND AIMS: The use of a tourniquet during surgery is associated with a risk of neurological disorders. We compared whether a new tourniquet system using low pressure (250 mmHg) is safer than a standard tourniquet system using higher inflation pressure (350 mmHg). MATERIALS AND METHODS: Thirty-one patients (ASA I-II), ages 16-48 years, were studied with ENMG preoperatively and 3 weeks postoperatively following arthroscopic anterior cruciate ligament reconstruction. Tourniquet times varied between 30 and 146 min. RESULTS: Postoperative slowing of motor and sensory conduction was observed, as well as an increase of the minimum peroneal F-response and tibial H-reflex latencies. The sensory amplitude of the sural nerve decreased. Vastus medialis of the quadriceps femoris muscle showed a reduced interference pattern in ENMG in maximal voluntary effort postoperatively. No differences were found in measured results between the low and high pressure tourniquet systems. CONCLUSIONS: Slight postoperative ENMG alterations were demonstrated but the use of both tourniquet systems is safe within the limit of tourniquet times of less than 2 h.