{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:39:44Z","timestamp":1787071184613,"version":"build-2736575974"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","license":[{"start":{"date-parts":[[2024,12,1]],"date-time":"2024-12-01T00:00:00Z","timestamp":1733011200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,12]]},"abstract":"\n Background and Aims:<\/jats:title>\n Tourniquet-induced hypertension (TH) remains an unresolved issue. Various techniques, such as peripheral nerve blocks, peri-femoral artery blocks, and subcutaneous infiltration, have been explored to address this. The primary objective was to compare the incidence of TH during lower-limb surgery under general anaesthesia between peri-femoral artery block and subcutaneous infiltration, combined with femoral and sciatic nerve blocks. Secondary objectives included intraoperative intravenous fentanyl and antihypertensive uses, as well as postoperative pain scores.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n This single-centre, double-blind, randomised controlled trial involved 58 patients scheduled for elective lower-limb surgery. Participants were assigned to the peri-femoral artery block (P-FAB) or subcutaneous infiltration (SI) groups. All patients received general anaesthesia alongside femoral and sciatic nerve blocks. TH was defined as a 30% increase in systolic blood pressure from baseline. Pain was assessed using a numerical rating scale in the post-anaesthetic care unit and at 4, 8, 12, and 24 h post-surgery. Unpaired\n t<\/jats:italic>\n -test, Chi-square, and Mann-Whitney U test were used for analysis. A\n P<\/jats:italic>\n value less than 0.05 was considered to be statistically significant.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n There were no significant differences in the incidence of TH between the P-FAB and SI groups (\n P<\/jats:italic>\n = 1.00). Similarly, no significant differences were observed in intraoperative fentanyl (\n P<\/jats:italic>\n = 0.459) or antihypertensive use (\n P<\/jats:italic>\n = 0.992). Pain scores across all measured aspects, including thigh and incision sites, were also not significantly different between groups (\n P<\/jats:italic>\n > 0.05).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n In lower-limb surgery, adding a peri-femoral artery block to general anaesthesia with femoral and sciatic nerve blocks did not reduce the incidence of TH compared to subcutaneous infiltration.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ija.ija_968_24","type":"journal-article","created":{"date-parts":[[2024,12,3]],"date-time":"2024-12-03T12:00:29Z","timestamp":1733227229000},"page":"1035-1042","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Efficacy of local anaesthetic peri-femoral artery injection compared to subcutaneous infiltration in combination with femoral and sciatic nerve blocks for reducing thigh tourniquet-induced hypertension during lower-limb surgery under general anaesthesia: A randomised controlled double-blinded trial"],"prefix":"10.4103","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6036-5007","authenticated-orcid":false,"given":"Chonruethai","family":"Tangkittithaworn","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society and Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9311-3722","authenticated-orcid":false,"given":"Wirinaree","family":"Kampitak","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society and Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0000-9690","authenticated-orcid":false,"given":"Tanawat","family":"Benjamungkalarak","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society and Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7800-9951","authenticated-orcid":false,"given":"Jirun","family":"Apinun","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society and Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,12,3]]},"reference":[{"key":"R1-20260424","first-page":"228","article-title":"Femoral artery block (FAB) 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in the prevention of tourniquet pain during plexus block anaesthesia of the arm","volume":"53","author":"Tschaikowsky","year":"1998","journal-title":"Anaesthesia"},{"key":"R9-20260424","first-page":"2327753","article-title":"Effects of the femoral nerve block and adductor canal block on tourniquet response and postoperative analgesia in total knee arthroplasty","volume":"2022","author":"Jin","year":"2022","journal-title":"J Healthc Eng"},{"key":"R10-20260424","first-page":"595","article-title":"Prevention of tourniquet pain by subcutaneous injection into the posterior half of the axilla","volume":"61","author":"Kubota","year":"2008","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"R11-20260424","first-page":"510","article-title":"Comparison of the effects of axillary brachial plexus block, inhalation anesthesia, and total intravenous anesthesia on tourniquet-induced ischemia-reperfusion injury in upper extremity surgery","volume":"30","author":"Kutanis","year":"2024","journal-title":"Ulus Travma Acil Cerrahi Derg"},{"key":"R12-20260424","first-page":"1511","article-title":"Does the sciatic nerve approach influence thigh tourniquet tolerance during below-knee surgery?","volume":"100","author":"Fuzier","year":"2005","journal-title":"Anesth Analg"},{"key":"R13-20260424","first-page":"70","article-title":"Femoral artery block: The relationship between visceral and ischemic pain","volume":"47","author":"Boezaart","year":"2022","journal-title":"Reg Anesth Pain Med"},{"key":"R14-20260424","first-page":"363","article-title":"Real time measurement of intramuscular pH during routine knee arthroscopy using a tourniquet: A preliminary study","volume":"10","author":"MacDonald","year":"2021","journal-title":"Bone Joint Res"},{"key":"R15-20260424","first-page":"111039","article-title":"Combined femoral artery block and femoral nerve block reduces thigh tourniquet-induced hypertension","volume":"85","author":"Xu","year":"2023","journal-title":"J Clin Anesth"},{"key":"R16-20260424","first-page":"e171","article-title":"Is posterior femoral cutaneous nerve block clinically relevant in awake foot and ankle surgery?","volume":"126","author":"Hamilton","year":"2021","journal-title":"Comment on Br J Anaesth"},{"key":"R16-20260424","first-page":"e8","volume":"128","year":"2022","journal-title":"Br J Anaesth"}],"container-title":["Indian Journal of 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