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Tourniquet Inflation Pressure — FRCA Final MCQ

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ModerateAnaesthetic Equipment & SafetyTourniquet Inflation PressureFRCA Final

A 50-year-old woman (ASA II) is undergoing total knee replacement under spinal anaesthesia. The surgeon applies a pneumatic tourniquet. What is the recommended inflation pressure for a lower limb tourniquet?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Limb occlusion pressure (LOP) + 40 mmHg safety margin

Current best practice (AAGBI 2020, BOA) recommends tourniquet inflation pressure be individualised based on limb occlusion pressure (LOP) – the minimum pressure needed to stop arterial flow – plus a safety margin. For the lower limb: LOP + 40-80 mmHg (wider limbs need less margin). Fixed pressures of 250-300 mmHg may be excessive for some patients and insufficient for obese patients. LOP is determined by gradually inflating the cuff while monitoring distal pulse Doppler. Wider tourniquet cuffs occlude at lower pressures.

Reference: AAGBI – 2020 – Tourniquet safety guidelines; BOA – 2018 – Standards for tourniquet use