Incidence of Post-Surgical Chronic Pain following the use of tourniquet to minimize Surgical Blood Loss during Limb Surgery: A Clinical Survey

Li K, Liu Y, Ma H, Ahmed S and Wang J

Published on: 2023-11-18


Background: Tourniquet use is a common practice in lower extremity orthopedic surgeries aimed at reducing blood loss, improving surgical visualization, and shortening operative times. However, recent studies have shown limited functional and clinical benefits from tourniquet use, while also highlighting potential risks such as tourniquet-induced ischemic-reperfusion injuries, vascular and inflammatory complications, and the possible development of chronic neuropathic pain.

Objective: The aim of our study was to investigate the incidence of post-surgical chronic pain (PSCP) and identify possible factors associated with its onset following tourniquet application during orthopedic surgeries aimed at minimizing intraoperative blood loss.

Study Design: We conducted a preliminary retrospective chart review to evaluate the occurrence of PSCP in patients who had undergone orthopedic surgery with and without tourniquet use.

Setting: Our sample population included patients of a selected group of orthopedic surgeons.

Methods: We utilized a preliminary retrospective chart review and telephone interviews using a clinical survey to gather data. No interventions were administered. We collected demographic variables, including age, gender, ASA status, weight, and clinical outcomes of pain. A statistician analyzed the data using R and R studio.

Results: Our results suggest that tourniquet use is not statistically significant or associated with the development of PSCP, although age, ASA status, and weight may be associated with PSCP.

Limitations: Limitations of this study include a small sample size, challenges with long-term follow-up, procedure bias and outcome bias due to the sample selection of patients from a specific group of surgeons. Difficulties in contacting patients and issues with follow-up are also limitations.

Conclusion: These results indicate that the tourniquet time is not significantly associated with the development of PSCP. However, further research is needed to identify risk factors for the development of chronic pain following orthopedic surgery.