ABSTRACT
The tourniquet should be applied to the limb with appropriate soft padding below. The tourniquet is inflated and the time noted both on the anesthetic chart and by theatre staff. The anesthetist should be warned prior to tourniquet release, and the total tourniquet time is recorded in the operation notes. The site of tourniquet application should be inspected by the surgeon postoperatively. The ideal tourniquet inflation is the minimal effective tourniquet pressure for the minimum time required. The tourniquet should be deflated every 90–120 minutes for 10 minutes to allow reperfusion and prevent distal ischaemic injury. The common injuries of tourniquet site are to the ulnar, median and sciatic nerves, where neuropraxia results. The risks of tourniquet use are haemodynamic changes at the time of tourniquet inflation and deflation, hypercapnoea and metabolic changes with increased potassium and lactate influx from the involved limb after deflation, hypercoagulability, and pulmonary embolism.
