Effects of special waterproof layer under tourniquet cuff on the incidence of burns and pain intensity and satisfaction of operating room staff in knee arthroscopic surgeries: a randomized clinical trial.

Abstract

The use of multiple layers of vibril under tourniquet cuffs is common. However, these layers can lead to complications. We designed a special waterproof curtain for use under tourniquet cuffs. Its effects on burns, postoperative pain, and operating room staff satisfaction were evaluated. In this randomized clinical trial, 34 patients underwent arthroscopic surgery of the knee joint in the operating rooms of selected hospitals at Isfahan University of Medical Sciences in 2022 via a simple random method. Even and odd days were divided into two groups: Group A (even days: special tourniquet drape: 17 people) and Group B (odd days: usual layers under the pneumatic tourniquet cuff: 17 people). The degree of pain was evaluated with a visual analog scale (VAS), the severity of burns was evaluated on the basis of a rating from one to four, and the satisfaction of the operating room personnel was evaluated via a standardized questionnaire with 10 questions. Pain intensity was lower in Group A than in Group B at all times: immediately after recovery (2.29 ± 0.47 vs. 5.00 ± 0.71, P < 0.001), during the first eight hours (1.71 ± 0.47 vs. 3.94 ± 0.56, P < 0.001), during the second eight hours (2.82 ± 0.73 vs. 5.12 ± 0.45, P < 0.001), and during the third eight hours (1.65 ± 0.61 vs. 3.59 ± 0.62, P < 0.001). None of the participants in Group A and only one participant (5.9%) in Group B suffered burns, a difference that was not significant (P = 0.5). Most of operating room personnel (82.4%) reported a "high" level of satisfaction. The use of a special tourniquet in arthroscopic surgeries of the knee joint seems to have a positive effect, considering the reduction in postoperative pain and the increase in the level of satisfaction of the operating room personnel.