Subtourniquet pressures generated by application of wide-rubber tourniquets in standing, sedated horses.
Authors: Plunkett Amanda H, Schoonover Mike J, Young Jenna M, Taylor Jared D, Holbrook Todd C
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Subtourniquet Pressures with Wide-Rubber Tourniquets in Horses Wide-rubber tourniquets (WRTs) are commonly applied during regional limb perfusion procedures in equine surgery, yet little was known about the pressures they actually generate or maintain in clinical practice. Researchers applied WRTs to three different locations on sedated horses' limbs—the antebrachium, gaskin, and midmetacarpus—and measured subtourniquet pressure (STP) at 10-minute intervals over 30 minutes whilst also recording systolic blood pressure and limb movement patterns. Mean STP remained stable across the half-hour period but varied significantly by location: the antebrachium generated pressures 163 mm Hg above systolic blood pressure, the gaskin 185 mm Hg above, and notably the midmetacarpus 402 mm Hg above. Encouragingly, 81% of tourniquet applications achieved or exceeded the recommended target (systolic blood pressure + 100 mm Hg), demonstrating that WRTs are generally reliable for achieving adequate ischaemia; however, limb movement—particularly at the antebrachium and midmetacarpus—caused measurable pressure reductions, suggesting that restraint quality during regional anaesthesia procedures directly influences tourniquet efficacy. For practitioners, this underscores the importance of minimising patient movement during tourniquet application to maintain consistent drug delivery and surgical safety.
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Practical Takeaways
- •Wide-rubber tourniquets reliably achieve and maintain adequate pressures for regional limb perfusion in standing, sedated horses for at least 30 minutes
- •Minimize patient movement during tourniquet application, particularly at the forearm and cannon bone, as motion can reduce tourniquet efficacy
- •Gaskin tourniquets appear more stable and less affected by limb movement, making this location potentially more reliable for regional anesthesia procedures
Key Findings
- •Wide-rubber tourniquets generated mean subtourniquet pressures exceeding systolic blood pressure by 163 mm Hg (antebrachium), 185 mm Hg (gaskin), and 402 mm Hg (midmetacarpus)
- •Mean subtourniquet pressure did not change over 30 minutes of tourniquet application (P = 0.93)
- •Subtourniquet pressure exceeded target (SBP + 100 mm Hg) in 81% of trials across all three locations
- •Limb movement significantly affected pressure at antebrachium and midmetacarpus but not at gaskin location