Comparison of Blood Pressure Measurement between Different Directions of Cuff tube in Tucked Arm Surgery: A Randomized Control Trial

Abstract

Background: During blood pressure (BP) measurement, the standard positioning of cuff tube is on the downside direction. However, the use of upside cuff tube direction may be more suitable in some situations to minimize an event of bend or to reduce a chance of compression by surgical team. Therefore, we investigated the difference of BP measurement between two methods. Methods: Thirty adult patients scheduled for thyroid surgery were enrolled and got BP measurements of both arms. They were randomized to receive upside cuff tube placement in one arm and downside on the other. BP was measured during preoperative period and intra-operative period every 15 minutes till the end of operation or 2 hours. Results: Systolic blood pressure (SBP) was significantly different in preoperative on the right arm side, the mean SBP in the upside cuff tube direction was 129.33 ± 23.78 mmHg and in the downside cuff tube direction was 132.80 ± 21.29 mmHg (p= 0.017). Diastolic blood pressure (DBP) and mean blood pressure (MAP) were found not significantly different between upside and downside cuff tube direction. The number to repeat measurement of blood pressure during intra-operative period was not significantly different (p= 0.940) between upside and downside cuff tube direction (upside median was 1 and 4, respectively). Conclusions: There was only significant different in systolic blood pressure in different cuff tube direction during preoperative at the right arm. However, this difference was not clinically important.