Intermittent reperfusion fails to prevent posttourniquet neurapraxia

This study examined the effects of intermittent reperfusion on peripheral n erve function. Rabbits were randomized to undergo 4 hours of 350 mm Hg tour niquet compression to a hind limb either continuously, interrupted by a sin gle 10-minute reperfusion interval after 2 hours, or interrupted by 10 minu tes of reperfusion after each hour. A control group had the tourniquet appl ied for 4 hours but it was never inflated. The animals were examined clinic ally for neuromuscular dysfunction and the structure and function of the pe ripheral nerves were evaluated 1 week after tourniquet compression. Animals that underwent compression had a foot drop and decreased toe-spread reflex . There was greater intraneural edema and slower nerve conduction velocity in nerve segments that were directly compressed by the tourniquet but no ap parent abnormalities in segments distal to the tourniquet. Intermittent rep erfusion failed to diminish the clinical, structural, or functional consequ ence of the neurologic injury. (J Hand Surg 1999;24A:3687-693. Copyright (C ) 1999 by the American Society for Surgery of the Hand.).