Publication:

Role of tourniquet in post-operative pain after total knee replacement surgery: a case control study

Background Intraoperative use of tourniquet to double the systolic blood pressure during total knee replacement (TKR) is used commonly for maintaining bloodless field. The aim of this study is to understand the role of tourniquet in post-operative pain after a TKR.

Methods Using a case-control design we enrolled 20 patients who underwent TKR with intraoperative use of tourniquet and 20 age and gender matched controls who underwent TKR without the use of tourniquet, from November 2014 till May 2016 in the Department of Orthopedics at the A.J. Institute of Medical Sciences, Mangalore. Baseline demographic information was collected for all patients and pain was measured using simplified verbal scale (SVS). Statistical analysis was performed using unpaired t-test and ANOVA.

Results Average age of cases and controls was 62.8±7.47 and 63.1±7.21 years respectively, with no significant difference between them. The average SVS score on Day 1 was significantly different between the cases and controls, p value 0.0032. On Day 2 and Day 3 SVS scores were not different significant. For cases the mean difference was 0.77 and -1.3 when we compared scores of SVS on Day 2 and Day 1. For control subjects mean difference was 0.939 and 0.760 when we compared SVS scores on Day 3 and Day 1.

Conclusions We found significantly lower post-operative pain upto Day 3 in patients who underwent TKR without a tourniquet.