Clinical efficacy and risk factors of pneumatic tourniquet in orthopedic limb surgery:a prospective observational cohort study
CAI Wenjin
LIU Suiyu
PAN Chengtong
CHEN Xin
LÜ Xia
LIU Bi
Abstract：Objective To investigate the clinical efficacy and risk factors of pneumatic tourniquet in orthopedic limb surgeries and analyze their effects and related influencing factors across different surgical subtypes(e.g.,trauma,arthroplasty,arthroscopy)in upper and lower limb procedures.Methods A prospective observational cohort study was conducted,enrolling 30 patients from Shenzhen People's Hospital from November to December 2024.Patients were stratified by surgical sites into an upper limb group(n=6;subtypes:5 trauma,1 arthroscopy)and a lower limb group(n=24;subtypes:13 arthroplasty,8 trauma,3 arthroscopy).Intraoperative blood loss,surgical field quality,postoperative physiological parameters(blood pressure,limb circumference,VAS pain score),laboratory markers(hemoglobin,D-dimer,C reactive protein),and neurological recovery were recorded.Results In the upper limb group,trauma surgery patients exhibited an 83.2%increase in postoperative D-dimer levels,significantly higher than the 78.9%increase in arthroscopy patients.In the lower limb group,arthroplasty patients demonstrated the largest D-dimer elevation(237%)and had lower postoperative VAS scores(3.0±1.0)compared to trauma patients(4.1±0.8,P=0.01).All neurological abnormalities resolved by postoperative day 3.Age was correlated with the amount of lower limb blood loss(r=0.32),while BMI was correlated with the changes in limb circumference(r=0.41,P<0.05).Conclusion Pneumatic tourniquets effectively optimize the surgical field in orthopedic procedures.Additionally,patient age showed a significant correlation with intraoperative blood loss and D-dimer increase in tourniquet-assisted surgeries,while BMI correlated significantly with changes in lower limb circumference,indicating that patients with larger limb circumferences may experience higher rates of postoperative limb swelling and neurological and limb sensory abnormalities compared to those with smaller limb dimensions.Therefore,enhanced monitoring and rehabilitation exercises are necessary after surgery.
Keywords：pneumatic tourniquetorthopedic surgeryclinical efficacyrisk factorprospective observational cohort
Publication Date：2025-08-20
Online Publishing Date：2025-09-22(First online date of this platform, not the publication date of the document)
Pages：6( 978-983 )