Efficacy of three tourniquet types for intravenous antimicrobial regional limb perfusion in standing horses.

The research article investigates the effectiveness of three different types of tourniquets (narrow rubber, wide rubber, and pneumatic) in regional limb perfusion in standing horses when delivering amikacin sulfate through their veins. The study found that using the pneumatic tourniquet yielded the highest concentrations of amikacin in the horses’ synovial fluid, although both the pneumatic and wide rubber tourniquets achieved adequate drug concentrations. The narrow rubber tourniquet was deemed ineffective.

Objective and Methodology

• The primary goal of the research was to discern if clinically useful concentrations of amikacin sulfate, an antimicrobial agent, can be achieved in the synovial fluid of standing sedated horses during regional limb perfusion performed above the carpus (a part of a horse’s limb). The study also aimed to assess the efficacy of three types of tourniquets: narrow rubber, wide rubber, and pneumatic.
• The researchers used nine horses for the study. All the horses underwent bilateral forelimb regional limb perfusion with 2.5 g of amikacin sulfate administered through the cephalic vein.
• The limbs of the horses were randomly assigned to one of the three tourniquet types, which were applied above the carpus.
• Half an hour post-perfusion, the metacarpophalangeal synovial fluid was taken from horses. The presence of amikacin in the synovial fluid was detected using fluorescence polarization immunoassay, a technique used for measuring the amount of specific substances in a sample.

Results

• The study found that the mean concentrations of amikacin in the synovial fluid were markedly higher in the horses with the pneumatic and wide rubber tourniquets when compared to the narrow rubber tourniquet.
• The pneumatic tourniquet had a mean amikacin concentration of 236 μg/mL while the wide rubber tourniquet had a mean concentration of 64.2 μg/mL. Both of these were significant rises from the 2.1 μg/mL mean concentration observed in the narrow rubber tourniquet applied limbs.

Conclusions

• The study concluded that the pneumatic tourniquet resulted in the highest synovial fluid amikacin concentrations in all horses.
• Both the pneumatic and wide rubber tourniquets were effective in achieving adequate concentrations of the drug, but the narrow rubber tourniquet was found to be ineffective.
• As a result of these findings, the researchers propose that the narrow rubber tourniquet should not be used for regional limb perfusion performed above the carpus in standing horses.