Evidence map›Paper›PMID 38698470›Full record

Trial reportJournal of orthopaedic surgery and research2024

Randomised controlled trial of tourniquet associated pain generated in lower limb after exsanguination by Esmarch bandage versus limb elevation.

Alexander Mitrichev, John Maunder, Aiden Jabur, Prince Singh, Deborah Lees, Levi Morse, Benjamin Parkinson

Abstract readRandomized Controlled TrialComparative Study
In one paragraph

Trial report in Journal of orthopaedic surgery and research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Trial
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Alexander MitrichevPrincess Alexandra Hospital Orthopaedic Department, 199 Ipswich Road, Woolloongabba, QLD, 4102, Australia.ORCID http://orcid.org/0000-0002-7335-2299
John MaunderPrincess Alexandra Hospital Orthopaedic Department, 199 Ipswich Road, Woolloongabba, QLD, 4102, Australia.ORCID http://orcid.org/0000-0002-0875-7951
Aiden JaburPrincess Alexandra Hospital Orthopaedic Department, 199 Ipswich Road, Woolloongabba, QLD, 4102, Australia. aidenjabur@gmail.com.ORCID http://orcid.org/0000-0001-7380-6134
Prince SinghTownsville General Hospital Orthopaedic Department, Townsville, Australia.
Deborah LeesCairns Base Hospital Orthopaedic Department, Cairns, Australia.
Levi MorseTownsville General Hospital Orthopaedic Department, Townsville, Australia.
Benjamin ParkinsonCairns Base Hospital Orthopaedic Department, Cairns, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTourniquets are common adjuncts in the operating theatre but can be associated with post-operative pain. This study was designed to compare what effect pre-tourniquet Esmarch bandage exsanguination has on pain, compared to pre-tourniquet exsanguination by elevation alone.

methods52 volunteers (104 lower limbs) were included in this study with each volunteer acting as their own matched control. The primary outcome was patient reported pain, measured in both legs simultaneously using area under curve. Secondary outcomes were pain score during inflation and deflation, cumulative pain score, duration of recovery and blood pressure during testing.

resultsPain after Esmarch was superior to elevation as measured by area under pain curve (68.9 SD 26.1 vs 77.2 SD 27.3, p = 0.0010), independent of leg dominance. Cumulative pain scores demonstrated the same superiority after inflation (50.7 SD 17.1 vs 52.9 SD 17.0, p = 0.026) but not after deflation (p = 0.59). Blood pressure was not significantly different. Time to full recovery of the lower limb was the same for both groups-7.6 min (SD 2.1 min, p = 0.80).

conclusionPrevious studies describe a positive effect on pain when Esmarch bandage was used prior to tourniquet inflation for upper limb. Our findings suggest the same benefit from Esmarch when it was used on lower limbs-particularly during inflation of tourniquet. In addition to pain profiles, surgeon preference and patient factors need to be considered when deciding between elevation and Esmarch bandage.

Indexed as

Lower ExtremityPostoperative PainTourniquetsAdultBandagesExsanguinationFemaleHumansMaleMiddle AgedPain MeasurementYoung AdultLower limbPainTourniquet

Identifiers

PMID38698470
PMCPMC11067074

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.