Dexmedetomidine versus ketorolac as adjuvants for intravenous regional anesthesia

Abstract

Background Multiple adjuvants have been added to improve the quality of intravenous regional anesthesia (IVRA). The aim of this study was to compare the effect of dexmedetomidine with that of ketorolac as an adjuvant for lidocaine IVRA as regards the onset and duration of sensory and motor blocks, intraoperative-postoperative pain, and intraoperative and postoperative analgesic requirement. Patients and methods This study was a prospective, randomized, double-blinded trial. Sixty patients scheduled for hand or forearm surgery were randomly divided into three equal groups ( n = 20): group I was given 3 mg/kg of lidocaine 2% (maximum: 200 mg) + 0.5 μg/kg of dexmedetomidine; group II was given 3 mg/kg of lidocaine 2% (maximum: 200 mg) + 30 mg ketorolac; and group III was given 3 mg/kg of lidocaine 2% (maximum: 200 mg). In the three groups, 0.9% normal saline was added for a total volume of 40 ml. Sensory and motor block onset, recovery times, intraoperative and postoperative analgesic requirement, and hemodynamic variables were recorded and compared between the three groups. Results There was a significant reduction in sensory and motor onset, and prolonged sensory and motor duration in the dexmedetomidine group than in the ketorolac and the control group, and in the ketorolac group than in the control group ( P < 0.001). There was improved tolerance to tourniquet and postoperative pain, with low levels of intraoperative and postoperative analgesic requirement in the dexmedetomidine group than in the ketorolac group followed by the control group. Conclusion We concluded that dexmedetomidine seems to be superior to ketorolac as an adjuvant to lidocaine in IVRA in terms of tourniquet pain and intraoperative and postoperative analgesic requirements.