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Subtourniquet pressures generated by application of wide‐rubber tourniquets in standing, sedated horses
Author(s) -
Plunkett Amanda H.,
Schoonover Mike J.,
Young Jenna M.,
Taylor Jared D.,
Holbrook Todd C.
Publication year - 2019
Publication title -
veterinary surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.652
H-Index - 79
eISSN - 1532-950X
pISSN - 0161-3499
DOI - 10.1111/vsu.13181
Subject(s) - medicine , tourniquet , horse , anesthesia , crossover study , pathology , paleontology , biology , alternative medicine , placebo
Abstract Objective To determine the influence of location and movement on subtourniquet pressure (STP) generated by application of a wide‐rubber tourniquet (WRT) on equine limbs. Study design Randomized experimental cross‐over design. Animals Six standing, sedated horses. Methods Horses were sedated with detomidine hydrochloride (0.2 μg/kg IV), and 4 investigators applied WRTs to the antebrachium (AB), gaskin (GK), and midmetacarpus (MC) of each horse in a predetermined, randomized order. Subtourniquet pressure was consequently measured at 10‐minute intervals (T0, T10, T20, T30) for 30 minutes. Indirect systolic blood pressure (SBP) was measured presedation, postsedation, and throughout the tourniquet application period. Target STP was established as SBP + 100 mm Hg. Limb movements at each location were classified as none, low, moderate, or high, on the basis of counts and magnitude. Results Mean STP did not change with time ( P = .93) and exceeded SBP by 163 mm Hg (95% CI 122–205), 185 mm Hg (95% CI 156–214), and 402 mm Hg (95% CI 351–454) at the AB, GK, and MC, respectively. Mean STP at each location exceeded the target STP in 59 of 70 (81%) of the trials. Limb movements affected STP generated by tourniquets at the AB ( P = .04) and MC ( P < .0001) but not at the GK ( P = .67). Conclusion Wide‐rubber tourniquets applied at the AB, GK, and MC generated STP >100 mm Hg above SBP for 30 minutes in standing, sedated horses. Clinical significance Wide‐rubber tourniquets as applied in this study can achieve and maintain the current recommended STP (SBP + 100 mm Hg) for equine IV regional limb perfusion. Number and magnitude of limb movement can decrease STP over time, potentially reducing the efficacy of a WRT.