Low tourniquet pressure has less impact on lower extremity nerve innervation: comparison of different tourniquet pressures used with intraoperative neuromonitoring with a randomized controlled study

This study examined how different tourniquet pressures affect nerve activity during foot and ankle surgery.

The goal was to see if lower tourniquet pressure could reduce nerve damage compared to higher pressure during surgery.

We included 24 patients aged 18-65 who had foot and ankle surgery. They were randomly assigned to two groups:

Group 1: Tourniquet pressure of limb occlusion pressure (LOP) + 50 mmHg (12 patients).
Group 2: Tourniquet pressure of LOP + 100 mmHg (12 patients).

We measured the time it took for nerve signals to decrease and return after the tourniquet was removed.

Patients in Group 1 experienced 50% nerve signal loss at an average of 47 minutes.
Group 2 showed 50% loss earlier, at 34 minutes.
Full loss for all nerves occurred at 69 minutes in Group 1 and 56 minutes in Group 2.
Nerve signals returned to normal at 8.5 minutes for Group 1 and at 12.6 minutes for Group 2 after deflation.

These findings suggest that lower pressure is safer for preserving nerve function during surgery.

Using a lower tourniquet pressure positively affected nerve recovery times:

This research supports the use of lower tourniquet pressures to enhance safety during surgeries and improve recovery times.

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