Objective: To compare the incidences of cuff-related trauma, including skin creasing and petechiae, occurring with and
without padding in non-invasive arterial blood pressure measurement.

Materials and Methods: This prospective, non-randomized controlled study enrolled patients scheduled for elective surgery between May 2014 and August 2017. Automated, non-invasive, arterial blood pressure was measured in both arms of each patient, one taken with padding, and the other
without. Twelve measurements were obtained on each arm, and at the same time, at 5-minute intervals. Demographic characteristics, underlying diseases, anesthetic technique, side of intravenous catheter, blood pressure during the study period, and data of cuff-related trauma were recorded.

Results: Of the 300 enrolled patients, 273 were finally analyzed. The incidences of cuff-related skin creasing occurring with and without padding were not different (p = 0.134), while the incidences of cuff-related petechiae were statistically lower with the padding technique (p = 0.007). The number of patients having severe skin creasing and mild petechiae was significantly reduced with padding (p<0.05). The female gender was an associated factor of cuff-related skin creasing; a body mass index of more than 25 kg/m2 and the spinal anesthesia were associated factors of cuff-related petechiae.

Conclusion: The incidences of cuff-related petechiae and the severity of cuff-related skin creasing and petechiae were statistically reduced with the padding technique, compared to without padding. The female gender, a body mass index of more than 25 kg/m2 and the spinal anesthesia were associated factors of cuff-related trauma.

Keywords: Non-invasive blood pressure, Cuff-related trauma, Complications