Many of our patients undergoing orthopedic procedures endure prolonged tourniquet durations resulting in exhibit sympathetic symptoms clearly related to "tourniquet pain" that is quite resistant to narcotic treatment and anesthetic deepening. At times the tachycardia and hypertension requires administration of hypotensives and beta antagonists. What are your current repertoires for treating tourniquet pain?
hi,
its really difficult situation.it all depends what sort of anaesthesia you are giving.more common in regional blocks compared to spinal,epidural anaesthesia & gas anaesthesia which is associated with least tourniquet pain manifested by hpertension ,tachycardia etc.it also depends on intensity & level of regional anaesthetic block.choice of local anaesthesist & spplementation of block with opioids also matters a lot.if deepening of anaesthesia & substantial analgesia also doesn't relieve the pain then last resort is deflation of cuff which will immediately relieve the pain & hypertension.
ketamin a versatile analgesic and anesthetic. small dose 15-25mg can reduce torniquet pain and increased blood pressure associated with pain. this is surprising ! try this
Nice Halo, I use ketamine quite often but never for tourniquet pain. I can't wait to try it.