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Temporary application of an additional forearm tourniquet reduces the dose of lidocaine for intravenous regional anesthesia
Joint Authors
Abd al-Majid, Walid M.
al-Tahir, Walid M.
Source
Ain Shams Journal of Anesthesiology
Issue
Vol. 7, Issue 1 (30 Apr. 2014), pp.70-75, 6 p.
Publisher
Ain Shams University Faculty of Medicine Department of Anesthesiology
Publication Date
2014-04-30
Country of Publication
Egypt
No. of Pages
6
Main Subjects
Topics
Abstract EN
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.
American Psychological Association (APA)
Abd al-Majid, Walid M.& al-Tahir, Walid M.. 2014. Temporary application of an additional forearm tourniquet reduces the dose of lidocaine for intravenous regional anesthesia. Ain Shams Journal of Anesthesiology،Vol. 7, no. 1, pp.70-75.
https://search.emarefa.net/detail/BIM-654452
Modern Language Association (MLA)
Abd al-Majid, Walid M.& al-Tahir, Walid M.. Temporary application of an additional forearm tourniquet reduces the dose of lidocaine for intravenous regional anesthesia. Ain Shams Journal of Anesthesiology Vol. 7, no. 1 (Jan. / Apr. 2014), pp.70-75.
https://search.emarefa.net/detail/BIM-654452
American Medical Association (AMA)
Abd al-Majid, Walid M.& al-Tahir, Walid M.. Temporary application of an additional forearm tourniquet reduces the dose of lidocaine for intravenous regional anesthesia. Ain Shams Journal of Anesthesiology. 2014. Vol. 7, no. 1, pp.70-75.
https://search.emarefa.net/detail/BIM-654452
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references : p. 75
Record ID
BIM-654452