The use of a pneumatic tourniquet with the purpose of maintaining an operative field free of blood is a common practice in orthopedic surgery. Its use is associated with local and systemic consequences related to hemodynamic and reperfusion ischemia phenomena. Although is known that its use is not an innocuous measure, there is still certain degree blurriness regarding the potential metabolic and functional consequences that may result in the involved limb.

In this trial, the investigators are setting out to discriminate the effect of the pneumatic tourniquet on thigh muscle function (strength, tone and activation). The hypothesis is that the pneumatic tourniquet by itself causes a significant postoperative muscular dysfunction of the quadriceps and, thus, the main outcome will be the presence of postoperative quadriceps muscle dysfunction, defined as a fall greater than or equal to 10% of the maximal voluntary isometric contraction measured at 24 hours post surgery.

Inclusion Criteria:

• Patients undergoing forefoot surgery that requires the use of a pneumatic tourniquet
• American Society of Anesthesiologists classification 1-3

Exclusion Criteria:

• Ambulatory surgery
• Adults who are unable to give their own consent
• Pre-existing neuropathy or myopathy
• Contraindication of tourniquet use
• Bilateral surgery
• Pregnancy
• Hip, thigh, knee, leg or ankle pathologies that prevent or contraindicate using a dynamometer, tonometer or surface electromyographer
• Arterial hypertension with systolic pressures above 200mmHg
• Renal failure
• Hepatic failure

Surgical side can not be randomized. Only data assessor will be blinded.