Table 6: Tourniquet versus no tourniquet: study details and qualitative outcomes

Study

n treatment/

control

Comparison

Supplemental

analgesic

VAS scores and type of pain, where specified

Time to first analgesic request

Use of supplemental analgesic

Other important outcomes

Abdel-Salam 1995

(LoE 1)

40/40

Surgery with tourniquet inflated (exsanguinated limb) (T) vs. surgery without tourniquet inflated (Cont)

Postop: IM papaveretum (10–20 mg)

Cont superior (p<0.05) at the only time recorded (i.e. 4 h)

__

IM analgesia: Cont superior (T every 4 h, Cont about every 6 h; p<0.05); oral analgesia: NS by day 3

Functional outcomes

Time to straight-leg raising: Cont superior (p<0.05); range of active knee flexion: Cont superior at days 5 and 10 and at 6 weeks (note that text states significant differences, but p values are not given, and the table does not indicate significant differences); NS at 1 year postop; HSS score (function, pain): NS at 1 year and 2 years postop

Hospital stay

Length of hospital stay: NS

Vandenbussche 2002

(LoE 1)

40/40

Surgery with tourniquet inflated (exsanguinated limb) (T) vs. surgery without tourniquet (Cont)

Postop: PCA-morphine sulphate, IV

T superior at 6 h (p=0.0458), but NS at 24 or 48 h

__

Mean morphine requirement: NS over 1^st 2 days

Functional outcomes

Range of motion: T superior at day 5 (p<0.001), but NS on day 10 or at 3 months

Complications

Suction drainage blood loss and total number of blood units transfused: NS; overall blood loss: T superior (p=0.0165) Hospital stay

Length of hospital stay: NS

Wakankar 1999

(LoE 1)

37/40

Surgery with tourniquet inflated (exsanguinated limb) (T) vs. surgery without tourniquet (Cont)

Postop: PCA-morphine, IV

NS at 1 week, 6 weeks or 4 months (i.e. at all time points recorded)

__

Mean morphine requirement: NS at the time points recorded (i.e. 12 and 24 h)

Functional outcomes

Knee flexion and mean change in knee flexion: Cont superior at 1 week (p=0.03, in both cases), but NS at 6 weeks and 4 months

Complications

Blood loss, swelling, wound complications: NS

*Study*	*n treatment/* *control*	*Comparison*	*Supplemental* *analgesic*	*VAS scores and type of pain, where specified*	*Time to first analgesic request*	*Use of supplemental analgesic*	*Other important outcomes*
Abdel-Salam 1995 (LoE 1)	40/40	Surgery with tourniquet inflated (exsanguinated limb) (T) *vs.* surgery without tourniquet inflated (Cont)	Postop: IM papaveretum (10–20 mg)	Cont superior (p<0.05) at the only time recorded (i.e. 4 h)	__	IM analgesia: Cont superior (T every 4 h, Cont about every 6 h; p<0.05); oral analgesia: NS by day 3	Functional outcomes Time to straight-leg raising: Cont superior (p<0.05); range of active knee flexion: Cont superior at days 5 and 10 and at 6 weeks (note that text states significant differences, but p values are not given, and the table does not indicate significant differences); NS at 1 year postop; HSS score (function, pain): NS at 1 year and 2 years postop Hospital stay Length of hospital stay: NS
Vandenbussche 2002 (LoE 1)	40/40	Surgery with tourniquet inflated (exsanguinated limb) (T) *vs.* surgery without tourniquet (Cont)	Postop: PCA-morphine sulphate, IV	T superior at 6 h (p=0.0458), but NS at 24 or 48 h	__	Mean morphine requirement: NS over 1^st 2 days	Functional outcomes Range of motion: T superior at day 5 (p<0.001), but NS on day 10 or at 3 months Complications Suction drainage blood loss and total number of blood units transfused: NS; overall blood loss: T superior (p=0.0165) Hospital stay Length of hospital stay: NS
Wakankar 1999 (LoE 1)	37/40	Surgery with tourniquet inflated (exsanguinated limb) (T) *vs.* surgery without tourniquet (Cont)	Postop: PCA-morphine, IV	NS at 1 week, 6 weeks or 4 months (i.e. at all time points recorded)	__	Mean morphine requirement: NS at the time points recorded (i.e. 12 and 24 h)	Functional outcomes Knee flexion and mean change in knee flexion: Cont superior at 1 week (p=0.03, in both cases), but NS at 6 weeks and 4 months Complications Blood loss, swelling, wound complications: NS