This multicenter, prospective randomized controlled trial investigates the effect of dilute epinephrine irrigation versus tourniquet use on visual field clarity (VFC) during ankle arthroscopy. Patients are randomized into an epinephrine group (normal saline with 1 mL of 1:1000 epinephrine per 3 L bag; tourniquet placed but not inflated unless needed) or a standard tourniquet group. The primary outcome is arthroscopic visual field clarity assessed using a 4-point Likert-style numeric rating scale. Secondary outcomes include postoperative pain intensity at 2 and 24 hours (VAS), and the incidence of hypotension, bradycardia, and cardiovascular adverse events.
Able to understand the procedures and methods of the clinical trial
voluntarily provide written informed consent
Aged from 15 to 65 years old , regardless of sex
Diagnosed with a condition requiring ankle surgery
Patients who decline to participate in the study
Known history of heart disease (e.g., coronary artery disease, cardiac conduction abnormalities), diabetes, or asthma
Poorly controlled hypertension
Age under 15 years or above 65 years old
Parallel
Epinephrine group
DrugIrrigation fluid consisted of normal saline mixed with 1 mL of 1:1000 epinephrine per 3-liter bag. A tourniquet was placed but left deflated as a rescue measure and could be inflated intraoperatively if necessary.
Tourniquet group
DeviceStandard tourniquet application
Visual field clarity (VFC) under ankle arthroscopy, assessed using a 4-point Likert-style numeric rating scale (NRS)
Scores are integers ranging from 0 to 4, with higher scores indicating clearer visual field
Pain intensity at 2 and 24 hours postoperatively, assessed using the Visual Analog Scale (VAS)
Scores range from 0 to 10, with higher scores indicating more severe pain
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