Nitroglycerin Plus Morphine on Iv Patient Controlled Analgesia for Abdominal Surgery: The Effect on Postoperative Pain

Background: Some studies have reported the effect of nitroglycerin on the reduction of pain after surgery. Objectives: The primary goal of the current study was to evaluate the addition of nitroglycerin (as a nitric oxide donor) to morphine in patient-controlled analgesia. Besides, its effects on the reduction of pain and stability in hemodynamic indices after abdominal surgery are also investigated. Methods: The current study was performed on 60 patients as candidates for abdominal surgery. Morphine (0.75 mg/mL) and nitroglycerin plus morphine (morphine 0.5 mg/mL + TNG 15 μg/mL) infusions were used for control and case groups, respectively, with the same induction of anesthesia. The severity of postoperative pain, hemodynamic indices of systolic blood pressure, diastolic pressure, heart rate, respiratory rate, and nausea were measured after surgery (immediately, 2, 6, 12, and 24 hours after surgery). Results: The pain score decreased for both groups almost similarly. The mean systolic blood pressure was highly reduced in both groups. However, the mean diastolic blood pressure in the control group was considerably lower than that of the case group. Besides, the respiratory rate in the case group dramatically diminished and approached the normal value. Conclusions: Combined administration of nitroglycerin and morphine had no synergistic effects on reducing postoperative pain. However, it led to more stable hemodynamic indices and improved breathing, without any side effects.

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FRI0618-HPR EFFECTS OF MUSIC THERAPY ON PAIN, ANXIETY, AND VITAL SIGNS IN CHRONIC INFLAMMATORY RHEUMATIC DISEASES PATIENTS DURING BIOLOGICAL DRUGS INFUSION

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.6027 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 914.2-914

Author(s):

S. Boussaid ◽

M. Ben Majdouba ◽

S. Jriri ◽

M. Abbes ◽

S. Jammali ◽

...

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Music Therapy ◽

Systolic Blood Pressure ◽

Respiratory Rate ◽

Vital Signs ◽

Biological Therapies ◽

Biological Drugs ◽

Pain Anxiety ◽

The Mean

Background:Music therapy is based on ancient cross-cultural beliefs that music can have a “healing” effect on mind and body. Research determined that listening to music can increase comfort and relaxation, relieve pain, lower distress, reduce anxiety, improve positive emotions and mood, and decrease psychological symptoms. Music therapy has been used greatly in various medical procedures to reduce associated anxiety and pain. Patients have a high level of anxiety when they are in the hospital, this is the case of patients with rheumatic diseases who consult regularly to have intravenous infusion of biological therapies.Objectives:The purpose of this study was to examine the effectiveness of music therapy on pain, anxiety, and vital signs among patients with chronic inflammatory rheumatic diseases during intravenous infusion of biological drugs.Methods:Fifty patients were divided into two groups: The experimental group G1 (n=25) received drug infusion while lestening to soft music (30 minutes); and the control group G2 (n=25) received only drug infusion. Measures include pain, anxiety, vital signs (blood pressure, heart rate and respiratory rate). The pain was measured using visual analogic scale (VAS). The state-trait anxiety inventory (STAI) was used for measuring anxiety, low anxiety ranges from 20 to 39, the moderate anxiety ranges from 40 to 59, and high anxiety ranges from 60 to 80. Vital signs (systolic blood pressure [SBP], diastolic blood pressure [DBP], heart rate [HR], and respiratory rate [RR]) were measured before, during and immediately after the infusion.Statistical package for social sciences (SPSS) was used for analysis.Results:The mean age in G1 was 44.45 years (26-72) with a sex ratio (M/F) of 0.8. Including the 25 patients, 12 had rheumatoid arthritis, 10 had ankylosing spondylitis and 3 had psoriatic arthritis. The mean disease duration was 8 years. In G2, the mean age was 46 years (25-70) with a sex ratio (M/F) of 0.75, 12 had rheumatoid arthritis, 11 had ankylosing spondylitis and 2 had psoriatic arthritis. The mean disease duration was 7.5 years. The biological drugs used were: Infliximab in 30 cases, Tocilizumab in 12 cases and Rituximab in 8 cases.Before the infusion, the patients of experimental group had a mean VAS of 5/10±3, a mean STAI of 50.62±6.01, a mean SBP of 13.6 cmHg±1.4, a mean DBP of 8.6 cmHg±1, a mean HR of 85±10 and a mean RR of 18±3. While in control group the mean VAS was 5.5±2, the mean STAI was 50.89±5.5, the mean SBP was 13.4±1.2, the mean DBP was 8.8±1.1, the mean HR was 82±8 and the mean RR was 19±2.During the infusion and after music intervention in G1, the mean STAI became 38.35±5 in G1 versus 46.7±5.2 in G2 (p value=0.022), the mean SBP became 12.1±0.5 in G1 versus 13±1 in G2 (p=0.035), the mean DBP became 8.1±0.8 in G1 versus 8.4±0.9 in G2 (p=0.4), the mean HR became 76±9 in G1 versus 78±7 in G2 (p=0.04) and the mean RR became 17.3±2.1 in G1 versus 18.2±1.7 in G2 (p=0.39).This study found a statistically significant decrease in anxiety, systolic blood pressure and heart rate in patients receiving music interventions during biological therapies infusion, but no significant difference were identified in diastolic blood pressure and respiratory rate.Conclusion:The findings provide further evidence to support the use of music therapy to reduce anxiety, and lower systolic blood pressure and heart rate in patients with rheumatic disease during biological therapies infusion.References:[1] Lin, C., Hwang, S., Jiang, P., & Hsiung, N. (2019).Effect of Music Therapy on Pain After Orthopedic Surgery -A Systematic review and Meta-Analysis. Pain Practice.Disclosure of Interests:None declared

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RELATIONSHIP BETWEEN CARDIOVASCULAR DISEASES AND ANATOMOSIS OF ARTERIOVENOUS FISTULAR IN PATIENTS WITH REGULARLY HEMODIALYSIS

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2017.3.13 ◽

2017 ◽

pp. 88-92

Author(s):

Van Hien Pham ◽

Huu Vu Quang Nguyen ◽

Tam Vo

Keyword(s):

Heart Failure ◽

Blood Pressure ◽

Renal Failure ◽

Chronic Renal Failure ◽

Cardiovascular Diseases ◽

Systolic Blood Pressure ◽

Diastolic Blood Pressure ◽

Negative Correlation ◽

Mean Value ◽

The Mean

Background: Cardiovascular diseases are the leading cause of death in patients with chronic renal failure. When a patient undergoes dialysis, making AVF or AVG causes cardiovascular events. Understanding the relationship between complications: hypertension, heart failure, AVF or AVG (formation time, position, diameter) helps us monitor, detect, prevent and treatment of complications to limit the risk of death in patients with dialysis. Objective: Relationship between cardiovascular diseases and anatomosis of arteriovenous fistular in patients with regularly hemodialysis at Cho Ray Hospital. Methods: A cross-sectional study was conducted at Cho Ray Hospital from 2015 to 2016. The survey some cardiovascular diseases are done by clinical examination, tests for diagnostic imaging such as X-ray, electrocardiogram and echocardiogram: heart and diameter of anastomosis AVF, AVG. Results: The study population included 303 patients with chronic renal failure who were dialysis. Of which, patients aged 25-45 accounted for the highest proportion (43.9%). The proportion of male and female patients was similar (48.5% and 51.5% respectively). The mean value of systolic blood pressure on patients made AVF, AVG less than 12 months is higher than patients made AVF, AVG over 12 months, and there is negative correlation (r = -0.43) between AVF, AVG and systolic blood pressure (p <0.05). The mean value of diastolic blood pressure on patients made AVF, AVG less than 12 months is lower than patients made AVF, AVG over 12 months, and and there is positive correlation (r = -0.43) between AVF, AVG and diastolic blood pressure (p <0.05) (p <0.05). The prevalence of patients with heart failure made AVF, AVG over 12 months is higher than that of the under 12 months group, there is a negative correlation (r = - 0.43) between AVF, AVG diameter and EF index (p <0.05). Conclusion: It is important to note the diameter of anastomosis AVF, AVG in patients with chronic renal failure dialysis to limit cardiovascular complications, especially heart failure. Key words: Chronic kidney disease, hemodialysis.

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Comparison of Propofol and Thiopentone Anaesthesia (with Special Reference to Recovery Characteristics)

Anaesthesia and Intensive Care ◽

10.1177/0310057x8701500406 ◽

1987 ◽

Vol 15 (4) ◽

pp. 389-393 ◽

Cited By ~ 14

Author(s):

W. M. Weightman ◽

M. Zacharias

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Day Case ◽

Early Recovery ◽

Day Case Surgery ◽

Pain On Injection ◽

High Incidence ◽

Case Surgery ◽

Repeated Doses ◽

The Mean

Thiopentone and propofol were used for the induction and maintenance of anaesthesia in unpremedicated patients undergoing minor gynaecological procedures. There were no significant differences in the induction and maintenance characteristics except for a high incidence of pain on injection and a greater fall in the mean systolic blood pressure associated with propofol in comparison with thiopentone. Propofol was associated with a quicker early recovery as well as a faster psychomotor recovery, as tested by a peg-board. However, complete psychomotor recovery was not achieved for up to three hours in some patients receiving propofol and so caution is advised regarding the early street fitness of patients receiving repeated doses of the drug for day case surgery.

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The Antihypertensive Effects and Safety of LCZ696 in Patients with Hypertension: A Systemic Review and Meta-Analysis of Randomized Controlled Trials

Journal of Clinical Medicine ◽

10.3390/jcm10132824 ◽

2021 ◽

Vol 10 (13) ◽

pp. 2824

Author(s):

Su-Kiat Chua ◽

Wei-Ting Lai ◽

Lung-Ching Chen ◽

Huei-Fong Hung

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Randomized Controlled Trials ◽

Diastolic Blood Pressure ◽

Publication Bias ◽

Meta Analysis ◽

Systemic Review ◽

Controlled Trials ◽

Randomized Controlled ◽

The Mean

Background: The management of hypertension remains suboptimal throughout the world. Methods: We performed a random-effects model meta-analysis of randomized controlled trials to determine the effectiveness and safety of sacubitril/valsartan (LCZ696) for the treatment of high arterial pressure. Relevant published articles from PubMed, Cochrane base, and Medline were examined, and the last search date was December 2020. Only published randomized controlled trials and double-blind studies were selected for further analysis. The mean reductions in systolic blood pressure (msSBP) and diastolic blood pressure (msDBP) in the sitting position, as well as the mean reductions in ambulatory systolic blood pressure (maSBP) and ambulatory diastolic blood pressure (maDBP), were assumed as efficacy endpoints. Adverse events (AEs) were considered as safety outcomes. Results: Ten studies with a total of 5931patients were included for analysis. Compared with placebo, LCZ696 had a significant reduction in msSBP (weight mean difference (WMD) = −6.52 mmHg, 95% confidence interval (CI): −8.57 to −4.47; p < 0.001), msDBP (WMD = −3.32 mmHg, 95% CI: −4.57 to −2.07; p < 0.001), maSBP (WMD = −7.08 mmHg, 95% CI: −10.48 to −3.68; p < 0.001), maDBP (WMD = −3.28 mmHg, 95% CI: −4.55 to −2.02, p < 0.001). In subgroup analysis, only 200 mg and 400 mg LCZ696 showed a significant BP reduction. There was no difference in the AE rate between the LCZ696 and placebo groups (WMD = 1.02, 95% CI: 0.83 to 1.27, p = 0.54). Egger’s test revealed a potential publication bias for msSBP (p = 0.025), but no publication bias for other outcomes. Conclusion: LCZ696 may reduce blood pressure more efficaciously than traditional therapy in hypertensive patients without increasing adverse effects.

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Abstract P622: Racial Variation in White Matter Hyperintensity Progression in the ACCORDION MIND Study

Stroke ◽

10.1161/str.52.suppl_1.p622 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Alison L Herman ◽

Adam H De Havenon ◽

Guido J Falcone ◽

Shadi Yaghi ◽

Shyam Prabhakaran ◽

...

Keyword(s):

Blood Pressure ◽

White Matter ◽

Systolic Blood Pressure ◽

White Matter Hyperintensity ◽

Diabetic Patients ◽

Patient Race ◽

Black Patients ◽

The Mean ◽

White Patients

Introduction: White matter hyperintensities (WMH) are linked to cognitive decline and stroke. We hypothesized that Black race would be associated with greater WMH progression in the ACCORDION MIND trial. Methods: The primary outcome is WMH progression in mL, evaluated by fitting linear regression to WMH volume on the month 80 MRI and including the WMH volume on the baseline MRI. The primary predictor is patient race, with the exclusion of patients defined as “other” race. We also derived predicted probabilities of our outcome for systolic blood pressure (SBP) levels. Results: We included 276 patients who completed the baseline and month 80 MRI, of which 207 were white, 48 Black, and 21 Hispanic. During follow-up, the mean number of SBP, LDL, and A1c measurements per patient was 21, 8, and 15. The mean (SD) WMH progression was 3.3 (5.4) mL for blacks, 2.5 (3.2) mL for Hispanics, and 2.4 (3.3) mL for whites. In the multivariate regression model (Table 1), Black, compared to white, patients had significantly more WMH progression (β Coefficient 1.26, 95% CI 0.45-2.06, p=0.002). Hispanic, compared to white, patients did not have significantly different WMH progression (p=0.392), nor was there a difference when comparing Hispanic to Black patients (p=0.162). The predicted WMH progression was significantly higher for Black compared to white patients across a mean SBP of 117 to 139 mm Hg (Figure 1). Conclusions: Black diabetic patients in ACCORDION MIND have a higher risk of WMH progression than white patients across a normal range of systolic blood pressure.

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Longitudinal prospective observational type study about determinants of renal resistive index variations in chronic renal failure patients treated with conventional medical and dietetic therapy

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2017.4.305 ◽

2017 ◽

Vol 89 (4) ◽

pp. 305

Author(s):

Simone Brardi ◽

Gabriele Cevenini ◽

Vanni Giovannelli ◽

Giuseppe Romano

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Doppler Ultrasonography ◽

Urinary Albumin Excretion ◽

Resistive Index ◽

Renal Resistive Index ◽

The Mean ◽

Renal Doppler Ultrasonography ◽

Renal Doppler

Objective: This longitudinal prospective observational type study was conceived with the aim to examine the impact on renal resistive index (RRI) of the variables that we can manipulate with therapeutic and or dietetic interventions in a chronic kidney disease population in order to known which of these variables was statistically related to changes in RRI and therefore could become the object of the greatest therapeutic effort. Material and methods: This study was undertaken between May 2016 to May 2017 in the outpatient nephrology and urology clinic of San Donato Hospital in Arezzo. The study population (84 patients: 47 males and 37 females) was randomly selected among the chronic kidney patients (with various degrees of renal impairment) affected by hypertension and or diabetes mellitus. After a comprehensive medical examination these patients were submitted to determination of serum creatinine, glycated hemoglobin, 24-hour urinary albumin excretion and finally renal Doppler ultrasonography. Then the patients were submitted to a full therapeutic and dietetic intervention to ameliorate the renal impairment by a wide range of actions and after on average a one-year interval were submitted again to a new medical examination and a second determination of serum creatinine, glycated hemoglobin, 24-hour urinary albumin excretion and a new renal Doppler ultrasonography too. Results: The comparison between basal and final data revealed a slight reduction in the mean of bilateral renal resistance indices (Delta RRI: -0.0182 ± 0.08), associated to a slight increase in the mean glomerular filtration rate (Delta GFR: 0.8738 ± 10.95 ml/min/1.73 m2), a reduction in mean body weight (Delta weight: -1.9548 ± 5.26 Kg) and mean BMI (Delta BMI: -0.7643 ± 2.10 Kg/m2) as well as a reduction in the mean systolic blood pressure (Delta systolic blood pressure: -8.8333 ± 25.19 mmHg). Statistical analysis showed statistically significant correlations (p < 0.05) between Delta RRI and Delta weight (p < 0.03), Delta BMI (p < 0.02) and Delta systolic blood pressure (p < 0.05). Conclusion: Despite the many limitations the our study clearly identifies the targets (yet widely known) to act on to prevent kidney alterations related to RRI and provides further evidence, if any, of the utility of RRI as a key parameter in monitoring patients with chronic renal failure and as a valuable tool to drive the clinical efforts to contrast the kidney disease.

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Systolic blood pressure of dogs at hospital and domestic environment

Ciência Rural ◽

10.1590/s0103-84782012005000036 ◽

2012 ◽

Vol 42 (7) ◽

pp. 1242-1248

Author(s):

Frederico Aécio Carvalho Soares ◽

Elisa Barp Neuwald ◽

Verônica Santos Mombach ◽

Ana Elize Ribeiro D'Avila ◽

Francisco de Oliveira Conrado ◽

...

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Doppler Ultrasonography ◽

Serum Cortisol ◽

Serum Concentrations ◽

Pathological Conditions ◽

Healthy Dogs ◽

The Mean ◽

Veterinary Hospital ◽

At Home

The measurement of blood pressure (BP) is an important assessment of the cardiovascular system, being influenced by physical and pathological conditions. Certain situations of stress and anxiety during BP measurement can lead to elevated values in small animals, known in medicine as "white coat effect". The aim of this research was to compare systolic blood pressure (SBP) measurement using Doppler ultrasonography in 45 adult healthy dogs in two environments, at a veterinary hospital and at home. Comparison of heart rate, serum concentrations of cortisol and glucose intended to help the evaluation of the stress level of the animals. The mean of SBP at the veterinary hospital was 154.7mmHg and it was significantly (P<0.01) higher than at home (136.3mmHg). It was also observed that HR (mean=122.7bpm), and serum cortisol (median=4.5µg dL-1) and glucose (mean=95.9mg dL-1) concentrations were significantly higher (P<0.01) at the hospital, when compared with values obtained at home (109.6bpm; 1.5µg dL-1 and 85.5mg dL-1, respectively). In conclusion, the environment can influence SBP in dogs, due to factors related to stress.

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EFFECTIVENESS OF LAVENDER AROMATHERAPY AND CLASSICAL MUSIC THERAPY IN LOWERING BLOOD PRESSURE IN PREGNANT WOMEN WITH HYPERTENSION

Belitung Nursing Journal ◽

10.33546/bnj.301 ◽

2017 ◽

Vol 3 (6) ◽

pp. 750-756

Author(s):

Sri Maisi ◽

Suryono Suryono ◽

Melyana Nurul Widyawati ◽

Ari Suwondo ◽

Suryati Kusworowulan

Keyword(s):

Blood Pressure ◽

Music Therapy ◽

Systolic Blood Pressure ◽

Pregnant Women ◽

Classical Music ◽

Combination Group ◽

Control Group ◽

P Value ◽

The Mean ◽

And Control

Background: Hypertension during pregnancy remains high in Indonesia. It is a major cause of maternal death. Aromatherapy lavender and classical music therapy are considered effective in lowering blood pressure in hypertension.Objective: To examine the effect of lavender aromatherapy and classical music therapy in lowering blood pressure in pregnant women with hypertension.Methods: A quasy experimental study with pretest-posttest control group design. There were 52 pregnant women with the inclusion criteria selected as samples using simple random sampling, divided into lavender aromatherapy group, classical music group, combination of aromatherapy and music group, and control group. Sphygmomanometer was used to measure blood pressure. Mann Whitney and Post Hoc test were used for data analysis.Results: Results showed that four groups have a significant decrease in systolic blood pressure after given intervention with p-value <0.05. The mean decrease of systolic blood pressure among four groups was: lavender group (5.77 mmHg), music group (7.23 mmHg), combination group (9.54 mmHg), and control group (3.67 mmHg); and the mean decrease of diastolic blood pressure was: the lavender group (2.77 mmHg), music group (0.61 mmHg), combination group (8.23 mmHg), and control group (3.42 mmHg).Conclusion: there was a significant effect of lavender aromatherapy and classical music therapy in lowering blood pressure in pregnant women with hypertension. However, the combination of both interventions was more effective than lavender aromatherapy or music therapy alone.

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THE BLOOD PRESSURE OF NEWBORN INFANTS: INDIRECT DETERMINATION BY AN AUTOMATIC BLOOD PRESSURE RECORDER IN 20 INFANTS

PEDIATRICS ◽

10.1542/peds.25.1.50 ◽

1960 ◽

Vol 25 (1) ◽

pp. 50-53

Author(s):

Robert L. Morse ◽

Gordon L. Brownell ◽

James H. Currens

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Diastolic Blood Pressure ◽

Newborn Infants ◽

Indirect Determination ◽

Pressure Recording ◽

Automatic Blood Pressure ◽

Blood Pressures ◽

The Mean ◽

Blood Pressure Recording

Systolic and diastolic blood pressures have been determined in 20 infants by the use of an automatic blood pressure-recording machine. The mean systolic blood pressure was 7.1 cm Hg (range 5.8 to 9.5). The mean diastolic blood pressure was 5.2 cm Hg (range 4.2 to 6.4).

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Postoperative Tourniquet Pain in Patients Undergoing Foot and Ankle Surgery

Foot & Ankle Orthopaedics ◽

10.1177/2473011418s00423 ◽

2018 ◽

Vol 3 (3) ◽

pp. 2473011418S0042

Author(s):

Ashish Shah ◽

Eva Lehtonen ◽

Samuel Huntley ◽

Harshadkumar Patel ◽

John Johnson ◽

...

Keyword(s):

Blood Pressure ◽

Postoperative Pain ◽

Length Of Stay ◽

Systolic Blood Pressure ◽

Foot And Ankle ◽

Opioid Use ◽

Tourniquet Time ◽

Pain Scores ◽

Regional Nerve Block ◽

Ankle Surgery

Category: Other Introduction/Purpose: The tourniquet is commonly used in orthopedic surgeries on the upper and lower extremities to reduce blood loss, improve visualization, and expedite the surgical procedure. However, tourniquets have been associated with multiple local and systemic complications, including postoperative pain. Guidelines vary regarding ideal tourniquet pressure and duration, while the practice of fixed, high tourniquet pressures remains common. The relationship between tourniquet pressure, duration, and postoperative pain has been studied in various orthopaedic procedures, but these relationships remain unknown in foot and ankle surgery. The purpose of this study was to assess for correlation between excessive tourniquet pressure and duration and the increased incidence of tourniquet pain in foot and ankle surgery patients. Methods: Retrospective chart review was performed for 132 adult patients who underwent foot and ankle surgery with concomitant use of intraoperative tourniquet at a single institution between August and December of 2015. Patients with history of daily opioid use of 30 or more morphine oral equivalents for greater than 30 days, patients who underwent foot and ankle surgery without regional nerve block, patients deemed to have failed regional nerve block, and patients who underwent foot and ankle surgery without tourniquet use were excluded. Patient’s baseline systolic blood pressure, tourniquet pressure and duration, tourniquet deflation time, tourniquet reinflation pressure and duration, intraoperative blood pressure and heart rate changes, intra-operative opioid consumption, PACU pain scores, PACU opioid consumption, and PACU length of stay were collected. Statistical correlation between tourniquet pressure and duration and postoperative pain scores, pain location, narcotic use, and length of stay in PACU was assessed using linear regression in SPSS. Results: Average age of patients was 47.6 years (Range: 16 - 79). Tourniquet pressure was 280 mmHg in 90.6% of patients (Range: 250-300 mmHg). Only 3.8% percent of patients had tourniquet pressures 100-150 mmHg above systolic blood pressure. Mean tourniquet time was 106.2 ± 40.1 min. Tourniquet time showed significant positive correlation with morphine equivalents used in the perioperative period (N = 121; r = 0.406; p < 0.001). Long tourniquet times (= 90 minutes) were associated with greater intraoperative opioid use than short tourniquet times (= 90 minutes) (19 mg ± 22 mg vs. 5 mg ± 11.6 mg; p <0.001). Tourniquet duration and PACU length of stay had a positive association (R2 = 0.4). Conclusion: The majority of cases of foot and ankle surgery at our institution did not adhere to current tourniquet use guidelines, which recommend tourniquet pressure between 100 and 150 mmHg above patient’s systolic blood pressure. Prolonged tourniquet times at high pressures not based on limb occlusion pressure, as observed in our study, lead to increased pain and opioid use and prolonged time in PACU. Basing tourniquet pressures on limb occlusion pressures could likely improve the safety margin of tourniquets, however randomized studies need to be completed to confirm this.

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