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This study investigated whether a minimal effective individualized occlusion pressure (MEIOP), calculated as limb occlusion pressure plus a safety margin, maintains surgical field quality while reducing pain compared to a standardized occlusion pressure (SOP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A preliminary survey of 79 orthopaedic surgeons identified 350\u00a0mmHg as the routine SOP. In a subsequent double-blind randomized clinical trial, patients undergoing elective knee arthroscopy were assigned to SOP (350\u00a0mmHg) or MEIOP, defined as Doppler-derived limb occlusion pressure plus a safety margin (mean \u2248 230\u00a0mmHg). Outcomes included surgical field quality, postoperative using a visual analog scale (VAS) up to 15\u00a0days, overall 15-day pain perception, and analgesic consumption.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Both groups achieved 100% excellent surgical field ratings. Pain trajectories differed significantly between groups over time (group\u2009\u00d7\u2009time interaction,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.022). The MEIOP group experienced significantly lower pain at discharge (~\u20096\u00a0h;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.013, d\u2009=\u20091.14) and lower overall 15-day pain perception (p\u2009=\u20090.043, d\u2009=\u20090.89). Analgesic consumption showed a consistent descriptive trend favoring MEIOP throughout follow-up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This proof-of-concept study suggests that individualizing tourniquet pressure using predefined MEIOP protocol preserves satisfactory surgical visualization and is associate with lower postoperative pain compared with a standard high-pressure protocol. This trial was prospectively registered at the Brazilian Clinical Trials Registry (ReBEC; RBR-4xd6cxm).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00264-026-06926-9","type":"journal-article","created":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T02:41:43Z","timestamp":1782528103000},"page":"2255-2264","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Optimizing tourniquet pressures in knee arthroscopy: an international survey on current practice and a double-blind randomized trial"],"prefix":"10.1007","volume":"50","author":[{"given":"Heber Oliveira","family":"Cardoso Filho","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Fajardo do Nascimento","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo","family":"Hohl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinicius Novais","family":"Rocha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manoel Carlos","family":"Couto de Araujo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rha\u00ed A.","family":"Arriel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel Dias","family":"Mendes Andrade","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moacir","family":"Marocolo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,27]]},"reference":[{"issue":"4","key":"6926_CR1","doi-asserted-by":"publisher","first-page":"424","DOI":"10.4103\/0970-9185.168174","volume":"32","author":"K Kumar","year":"2016","unstructured":"Kumar K, Railton C, Tawfic Q (2016) Tourniquet application during anesthesia: \u201cwhat we need to know?\u201d J Anaesthesiol Clin Pharmacol 32(4):424\u2013430. https:\/\/doi.org\/10.4103\/0970-9185.168174","journal-title":"J Anaesthesiol Clin Pharmacol"},{"issue":"7","key":"6926_CR2","doi-asserted-by":"publisher","first-page":"2568","DOI":"10.1016\/j.arthro.2024.11.082","volume":"41","author":"Y Yang","year":"2025","unstructured":"Yang Y, Zhang MQ, Zhang JM et al (2025) Tourniquet use in anterior cruciate ligament reconstruction may decrease operative time but is associated with muscular injury and postoperative pain: a systematic review and meta-analysis of randomized controlled trials. 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