INTRODUCTION: The use of multiple layers of vibril under tourniquet cuffs is common. However, these layers can lead to complications. We designed a special waterproof curtain for use under tourniquet cuffs. Its effects on burns, postoperative pain, and operating room staff satisfaction were evaluated. MATERIALS & METHODS: In this randomized clinical trial, 34 patients underwent arthroscopic surgery of the knee joint in the operating rooms of selected hospitals at Isfahan University of Medical Sciences in 2022 via a simple random method. Even and odd days were divided into two groups: Group A (even days: special tourniquet drape: 17 people) and Group B (odd days: usual layers under the pneumatic tourniquet cuff: 17 people). The degree of pain was evaluated with a visual analog scale (VAS), the severity of burns was evaluated on the basis of a rating from one to four, and the satisfaction of the operating room personnel was evaluated via a standardized questionnaire with 10 questions. RESULTS: Pain intensity was lower in Group A than in Group B at all times: immediately after recovery (2.29 ± 0.47 vs. 5.00 ± 0.71, P <
0.002), during the first eight hours (1.71 ± 0.47 vs. 3.94 ± 0.56, P <
0.002), during the second eight hours (2.82 ± 0.73 vs. 5.12 ± 0.45, P <
0.002), and during the third eight hours (1.65 ± 0.61 vs. 3.59 ± 0.62, P <
0.002). None of the participants in Group A and only one participant (5.9%) in Group B suffered burns, a difference that was not significant (P = 0.5). Most of operating room personnel (82.4%) reported a "high" level of satisfaction. CONCLUSION: The use of a special tourniquet in arthroscopic surgeries of the knee joint seems to have a positive effect, considering the reduction in postoperative pain and the increase in the level of satisfaction of the operating room personnel.