ORIGINAL ARTICLE
Year : 2014  |  Volume : 7  |  Issue : 1  |  Page : 70-75

Temporary application of an additional forearm tourniquet reduces the dose of lidocaine for intravenous regional anesthesia


Department of Anesthesia and Intensive Care, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Correspondence Address:
Waleed M Al Taher
Department of Anesthesia and Intensive Care, Faculty of Medicine, Ain Shams University, Cairo
Egypt
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1687-7934.128420

Rights and Permissions

Background Local anesthetic toxicity is a serious complication of intravenous regional anesthesia (IVRA). We investigated whether temporary application of an additional forearm tourniquet would permit the reduction of lidocaine dosage for IVRA without affecting the quality of the block. Patients and methods One hundred patients undergoing hand surgery under IVRA were randomized to receive ketorolac 10 mg with 40 ml of either 0.5% lidocaine (conventional group, N = 50) or 0.25% lidocaine and an additional simple forearm tourniquet applied for 5 min during and after administration of the local anesthetic (forearm group, N = 50). Results Surgical anesthesia occurred more rapidly in the forearm group (6.3 ± 1.4 vs. 8.4 ± 1.8 min in the conventional group, respectively; P < 0.001). There were no statistically significant differences in motor block onset and recovery times, intraoperative sedation requirement and operative conditions assessed by the surgeon between both groups. The mean ± SD verbal numerical scale values of quality of anesthesia were similar in both groups (3.2 ± 1.2 vs. 3.4 ± 1.1, P = 0.387). Time to the first analgesic requirement and the total postoperative analgesic consumption were similar in the studied groups. Significantly more patients in the conventional group experienced postoperative central nervous system manifestations than those in the forearm group (15 vs. three, respectively; P = 0.004). These manifestations were shorter lived in the forearm group (5 ± 2 vs. 16 ± 6 min, in conventional group; P < 0.0001). Conclusion Temporary application of an additional forearm tourniquet speeds the onset of IVRA and permits the use of half the dose of lidocaine, hence increasing the safety profile of the block.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed1900    
    Printed99    
    Emailed0    
    PDF Downloaded167    
    Comments [Add]    

Recommend this journal