Kumar Gupta Prateek, Khanna Vishesh, Acharya Ashis
Department of Sports Medicine, Sir Ganga Ram Hospital, New Delhi, India.
Wrighitngton Wigan and Leigh NHS Foundation Trust, UK.
J Orthop. 2021 Feb 4;23:233-238. doi: 10.1016/j.jor.2021.01.015. eCollection 2021 Jan-Feb.
Alternatives to tourniquets include portal-site epinephrine injections. This prospective, randomised-controlled, double-blinded study compared intraoperative visibility and safety of portal-site injections with tourniquets in arthroscopic meniscectomies.
Sixty eligible adults [16-55ys, excluding vascular/neuromuscular/systemic illnesses] were randomly/equally divided across 3 groups A (controls)-local portal injections; B-local injections with tourniquet; C-local and 1:200,000epinephrine injections. A single surgeon operated blinded to patient group. Intraoperative visibility, surgeon visual analogue score (VAS)and other details were recorded.
Superior visibility [p = 0.003,p = 0.027] and VAS [p = 0.010,p = 0.042] were reported in groups B, C versus A, Visibility [p = 0.705; p = 0.805] and operating times [p = 0.05] were comparable between B and C.
Portal-site epinephrine injections emerged as tenable surrogates for tourniquets for clear visualization in arthroscopy.
止血带的替代方法包括在切口部位注射肾上腺素。这项前瞻性、随机对照、双盲研究比较了关节镜半月板切除术时切口部位注射与使用止血带在术中的视野清晰度和安全性。
60名符合条件的成年人[16 - 55岁，排除血管/神经肌肉/全身性疾病]被随机平均分为3组：A组（对照组）——局部切口注射；B组——局部注射并使用止血带；C组——局部注射并注射1:200,000肾上腺素。由一名对患者分组不知情的外科医生进行手术。记录术中视野清晰度、外科医生视觉模拟评分（VAS）及其他细节。
与A组相比，B组和C组的视野清晰度更好[p = 0.003，p = 0.027]，VAS评分更低[p = 0.010，p = 0.042]。B组和C组的视野清晰度[p = 0.705；p = 0.805]和手术时间[p = 0.05]相当。
在关节镜检查中，切口部位注射肾上腺素可作为止血带的有效替代方法，以实现清晰的视野。
