Blood pressure measurement in volunteers with and without padding between the cuff and the skin.

Automated non-invasive arterial blood pressure measurements are made frequently during anaesthesia. Conscious patients often find the measurement uncomfortable. The tissues under the cuff can suffer trauma such as skin creasing, blistering, petechial haemorrhages and even nerve damage. We placed soft padding between the blood pressure measurement cuff and the skin of the upper arm of 140 healthy volunteers, and compared cuff-related skin trauma and arterial blood pressure measurements with and without the padding. Padding was associated with a significant reduction in the frequency and intensity of skin trauma (p < 0.0001). There was no significant overall effect of the presence of padding on arterial blood pressure readings. We conclude that the benefit of padding outweighs any compromise to the reliability of arterial blood pressure measurement.