Does the Use of a Tourniquet Influence Outcomes in Total Knee Arthroplasty: A Randomized Controlled Trial
| Autor: | David Yeroushalmi, Stephen Zak, Erik Schnaser, Morteza Meftah, Ran Schwarzkopf, William J. Long |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Visual analogue scale Operative Time Total knee arthroplasty law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law medicine Humans Orthopedics and Sports Medicine Arthroplasty Replacement Knee Pain Postoperative 030222 orthopedics Tourniquet business.industry Tourniquets equipment and supplies Analgesics Opioid surgical procedures operative Anesthesia Cohort Orthopedic surgery Morphine business Body mass index medicine.drug |
| Zdroj: | The Journal of Arthroplasty. 36:2492-2496 |
| ISSN: | 0883-5403 |
| DOI: | 10.1016/j.arth.2021.02.068 |
| Popis: | Background Intraoperative tourniquet use in total knee arthroplasty (TKA) is a common practice which may improve visualization of the surgical field and reduce blood loss. However, the safety and efficacy associated with tourniquet use continues to be a subject of debate among orthopedic surgeons. The primary purpose of this study is to evaluate the effects of tourniquet use on pain and opioid consumption after TKA. Methods This is a multicenter randomized controlled trial among patients undergoing TKA. Patients were preoperatively randomized to undergo TKA with or without the use of an intraoperative tourniquet. Frequency distributions, means, and standard deviations were used to describe baseline patient demographics (age, gender, race, body mass index, smoking status), length of stay, surgical factors, visual analog scale pain scores, and opioid consumption in morphine milligram equivalents. Results A total of 327 patients were included in this study, with 166 patients undergoing TKA without a tourniquet and 161 patients with a tourniquet. A statistically significant difference was found in surgical time (97.87 vs 92.98 minutes; P = .05), whereas none was found for length of stay (1.73 vs 1.70 days; P = .87), postop visual analog scale pain scores (1.73 vs 1.70; P = .87), inpatient opioid consumption (19.84 vs 19.27 morphine milligram equivalents; P = .74), or outpatient opioid consumption between the tourniquet-less and tourniquet cohorts, respectively. There were no readmissions in either cohort during the 90-day episode of care. Conclusion Utilization of a tourniquet during TKA has minimal impact on postoperative pain scores and opioid consumption when compared with patients who underwent TKA without a tourniquet. |
| Databáze: | OpenAIRE |
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