Purpose: Tourniquet is frequently used in hand surgery. Metabolic changes caused by ischemia has been widely studied and published. Our aim was to study the tourniquet related pain from the patient prospective. Materials and Methods: A prospective study was performed in our unit involving 312 patients. The type of operation, the form of anesthesia, and the duration of the procedure was registered, and the patient was asked about pain caused by the tourniquet, the operation, and the preparations for the procedure. The evaluation of the pain was done using a Visual Analogue Scale (VAS) of 1 to 10. The VAS form was filled 3 times for each patient: 2 hours, 1 day, and 1 week after the procedure. Results: Five patients were excluded from the study due to some administrative deficiencies. Finally, 921 data sheets from 307 patients were analyzed The overall pain level, caused by the whole procedure, was 2.71 points 2 hours after the procedure for patients in regional anesthesia (peripheral nerve block, distal to the tourniquet) and 1.62 points for the patients in general anesthesia. One week later, they remembered the pain as 2.17 points for blocks and 1.08 points for general anesthesia. In patients who had nerve block, the tourniquet caused pain was 2.61 in average, with 3.20 after the operation, presenting a peak of 4.7 points on the next day for procedures longer than 30 minutes. A week later, they remembered a pain of 2.88 points with no difference in relation with the length of the operation. Discussion: Our study showed that tourniquet can be used for hand surgical operations even in case of peripheral nerve blocks. Interventions shorter than 30 minutes were supported without major complaints. Longer operations needed some drug supplementation (fentanyl, dormicum). All our patients could support the tourniquet with minimal inconvenience. Comparing the pain caused by the anesthetic preparations (3.2), and the procedure itself (2.1), the pain caused by tourniquet (2.9) can be rated to be acceptable in our daily routine.
