Lidocaine For Intravenous Regional Anesthesia Research Articles

379: Addition of Dexmedetomidine or Neostigmine to Lidocaine for Intravenous Regional Anaesthesia

379: Addition of Dexmedetomidine or Neostigmine to Lidocaine for Intravenous Regional Anaesthesia

Addition of Midazolam to Lidocaine for Intravenous Regional Anesthesia

Addition of Midazolam to Lidocaine for Intravenous Regional Anesthesia

Adding Magnesium Sulfate to Lidocaine for Intravenous Regional Anesthesia

Adding Magnesium Sulfate to Lidocaine for Intravenous Regional Anesthesia

597. Addition of Midazolam to Lidocaine for Intravenous Regional Anesthesia

597. Addition of Midazolam to Lidocaine for Intravenous Regional Anesthesia

379. Addition of Dexmedetomidine or Neostigmine to Lidocaine for Intravenous Regional Anaesthesia

379. Addition of Dexmedetomidine or Neostigmine to Lidocaine for Intravenous Regional Anaesthesia

A Pilot Study: 0.2% vs. 0.5% Lidocaine For Intravenous Regional Anesthesia

Background: Standard intravenous regional anesthesia (IVRA) uses 3 mg/Kg of 0.5% lidocaine. However, a lower dose, larger volume lidocaine may be as effective. Methods: Randomized single blind study of emergency department patients with closed Colles fractures reduced with either 3 mg/Kg (0.6 mL/Kg) 0.5 % lidocaine (N=11) or 2 mg/Kg (1.0 mL/Kg) 0.2% lidocaine (N=10). Anesthesia outcome measured with 4-category pain rating scale. Results: Analysis of pooled data showed no significant difference in pain rating between IVRA methods (p=0.35). There were no significant differences in age, tourniquet time, or vital signs between groups. Mean body weight was 11.3 Kg less in experimental group (p<0.05). Mean±SD lidocaine volume and dose (standard vs experimental) were: 46.7±6.9 mL vs 66.9±12.4 mL, and 233.7±35.2 mg vs 133±24.8 mg. One woman (standard group) experienced transient lidocaine toxicity. Conclusion: Low-dose lidocaine is as effective and may be safer than the standard dose for IVRA. This study was conducted in the Department of Emergency Medicine at Los Angeles County-University of Southern California Medical Center, Los Angeles, CA, USA.

The analgesic effect of lornoxicam when added to lidocaine for intravenous regional anaesthesia

The aim of the study was to evaluate the effect of lornoxicam (L) on sensory and motor block onset time, tourniquet pain, and postoperative analgesia, when added to lidocaine in intravenous regional anaesthesia (IVRA). Forty-five patients undergoing hand surgery were randomly and blindly divided into three groups as to receive either i.v. saline and IVRA with lidocaine 0.5% (Control group, n=15), i.v. saline and IVRA lidocaine 0.5% with lornoxicam (L-IVRA group, n=15), or intravenous lornoxicam and IVRA lidocaine 0.5% (L-IV group, n=15). Sensory and motor blocks onset time, and tourniquet pain was measured after tourniquet application at 5, 10, 20, and 30 min, and analgesic use were recorded during operation. After the tourniquet deflation, at 1, 30 min, and 2, 4 h, visual analogue scales score, the time to first analgesic requirement, total analgesic consumption in first 24 h, and side effects were noted. Sensory and motor block onset times were shorter and the recovery time prolonged in the Group L-IVRA compared with the other group (P=0.001). A decreased tourniquet pain, a prolonged time first analgesic requirement [229 (85) min vs 28 (20) and 95 (24) min, P=0.0038) and less postoperative analgesic requirements during 24 h were found in Group L-IVRA compared with the other groups (P<0.05). The addition of lornoxicam to lidocaine for intravenous regional anaesthesia shortens the onset of sensory and motor block, decreases tourniquet pain and improves postoperative analgesia without causing any side effect.

Does addition of both ketorolac and dexamethasone to lidocaine intravenous regional anesthesia improve postoperative analgesia after ambulatory hand surgery: 58.

Does addition of both ketorolac and dexamethasone to lidocaine intravenous regional anesthesia improve postoperative analgesia after ambulatory hand surgery: 58.

58: Does addition of both ketorolac and dexamethasone to lidocaine intravenous regional anesthesia improve postoperative analgesia after ambulatory hand surgery

58: Does addition of both ketorolac and dexamethasone to lidocaine intravenous regional anesthesia improve postoperative analgesia after ambulatory hand surgery

Addition of cisatracurium to lidocaine for intravenous regional anesthesia

Study Objective To determine the onset and regression time of motor and sensory block, and the quality of anesthesia and postoperative analgesia by the addition of cisatracurium to local anesthetic solution in small doses in intravenous regional anesthesia. Design Prospective, randomized, double-blind study. Setting University hospital. Patients 40 ASA physical status I and II patients undergoing elective hand surgery. Interventions Intravenous regional anesthesia was achieved using 3 mg/kg lidocaine diluted with saline to a total volume of 40 mL in the control group or 0.01 mg/kg of cisatracurium plus 3 mg/kg lidocaine diluted with saline to a total volume of 40 mL in the cisatracurium group. Measurements The onset and the regression time for sensory and motor block were recorded. Quality of anesthesia, intraoperative, and postoperative analgesic requirements were noted. Mean arterial pressure and heart rate were recorded every 5 minutes. Main Results The onset time of sensory and motor block in the cisatracurium group was shorter than in the control group, and the difference was statistically significant. The quality of anesthesia was better in the cisatracurium group than in the control group, and the difference was statistically significant. There was no difference between the two groups with respect to sensory block regression time. Motor block regression time was statistically longer in the cisatracurium group than in the control group. Analgesic requirement was greater in the control group than in the cisatracurium group. Conclusion The addition of cisatracurium to lidocaine in intravenous regional anesthesia shortened the sensory and motor block onset times, improved the quality of anesthesia, and decreased analgesic requirements without causing clinical side effects.

Addition of dexmedetomidine to lidocaine for intravenous regional anaesthesia 1

The aim of this study was to determine the duration of onset and regression time of sensory and motor blocks, the quality of anaesthesia and postoperative analgesia by the addition of dexmedetomidine to local anaesthetic solution in intravenous regional anaesthesia (IVRA). Forty patients scheduled for elective hand surgery participated in this prospective randomized double-blind study. The IVRA was achieved using 3 mg kg(-1) lidocaine diluted with saline to a total volume of 40 mL in the control group or 1 microg kg(-1) of dexmedetomidine + 3 mg kg(-1) lidocaine diluted with saline to a total volume of 40 mL in the dexmedetomidine group. The onset and regression times for sensory and motor blocks were recorded. Qualities of anaesthesia, intraoperative and postoperative analgesic requirements were noted. There was no difference between the groups with respect to sensory and motor blocks onset and regression time. The quality of anaesthesia was better in the dexmedetomidine group than the control group and the difference was statistically significant. Intraoperative and postoperative analgesic requirements were greater in the control group than in the dexmedetomidine group. Addition of dexmedetomidine to local anaesthetic solution in IVRA improved the quality of anaesthesia and decreased analgesic requirements, but had no effect on the sensory and motor blocks onset and regression times.

The addition of dexmedetomidine to lidocaine for intravenous regional anesthesia

Department of Anesthesiology and Reanimation, Erciyes University, Medical Faculty; Department of Orthopaedic Surgery, Kayseri, Turkey

Adding magnesium to lidocaine for intravenous regional anesthesia

Adding magnesium to lidocaine for intravenous regional anesthesia

The effects of adding diphenhydramine hydrochloride to lidocaine in intravenous regional anaesthesia

This study aimed to evaluate whether diphenhydramine hydrochloride (DPH) could be used to reduce the dose of lidocaine for intravenous regional anaesthesia (IVRA). Sixty patients undergoing upper limb operations were divided into three groups (20 each). All patients received IVRA as follows: group 1 received 3 mg/kg lidocaine, group 2 received 40 mg DPH and 1.5 mg/kg lidocaine, and group 3 received 1.5 mg/kg lidocaine diluted to 40 ml with 0.9% saline solution. The onset of sensory block was tested by a pinprick. The duration of anaesthesia time was also recorded. Intraoperative pain was assessed using a five point pain score system. Side effects during surgery and after release of the tourniquet were recorded. Only 4 patients in group 3 had sufficient analgesia. Therefore, the patients in group 3 were excluded from the study. Data from 40 patients (group 1 and 2) were analysed. The onset time of sensory block was significantly shorter in group 1 than group 2 (2.4 ± 1.54 min and 6.85 ± 1.46 min, respectively). The tourniquet pain time was also significantly longer in group 1 than in group 2 (57.15 ± 10.90 min and 42.65 ± 9.67 min, respectively). One patient from each group experienced tinnitus for 30-60 s, and 4 patients in group 2 had minimal sedation after tourniquet release. According to our results, DPH is a safe and useful adjunct to IVRA in minor procedures of short duration. Decreasing the dose of lidocaine also decreases the risk of local anaesthetic toxicity in the event of accidental release of tourniquet pressure.

Comparison of Mepivacaine and Lidocaine for Intravenous Regional Anesthesia

Comparison of Mepivacaine and Lidocaine for Intravenous Regional Anesthesia

Comparison of ropivacaine and lidocaine for intravenous regional anaesthesia

Comparison of ropivacaine and lidocaine for intravenous regional anaesthesia

Comparison of ropivacaine and lidocaine for intravenous regional anaesthesia

Comparison of ropivacaine and lidocaine for intravenous regional anaesthesia

Comparison of anesthetic effect between 0.375% ropivacaine versus 0.5% lidocaine in forearm intravenous regional anesthesia

Background and Objectives: Ropivacaine was shown to provide superior postblock analgesia to lidocaine in intravenous regional anesthesia (IVRA) in voluntary studies. The objective of this study was to compare the anesthesia efficacy, postblock analgesia, and local anesthetic-related side effects between ropivacaine and lidocaine when forearm IVRA was used. Methods: Fifty-one patients undergoing outpatient hand surgery were randomized to receive forearm IVRA with either ropivacaine 0.375% or lidocaine 0.5%. The volume was 0.4 mL/kg up to 25 mL. Sensation to pinching by forceps and motor function was assessed at 5-minute intervals up to 15 minutes. After tourniquet deflation, verbal pain rating score (VRPS) at 15-minute intervals for the first 2 hours and time for first analgesic in the first 24 hours were evaluated. Results: Eleven patients were excluded from the study with 20 patients remaining in each group. Onset time of anesthesia (6.5 ± 2.9 minutes v 8.0 ± 4.1 minutes for lidocaine and ropivacaine groups, respectively) and motor block were similar. In the postoperative period, VPRS was significantly lower in the ropivacaine group in the first 60 minutes (median, 0; P < .05) with significantly more patients in the ropivacaine group pain free (VPRS, 0) up to the first 90 minutes (P > .05). More patients in lidocaine group requested analgesic in the first 2 hours postblock, and only patients in the lidocaine group required supplemental IV morphine in the recovery room. Twenty-four hour analgesic consumption was the same. No local anesthetic-related side effects were observed. Conclusions: We conclude that 0.375% ropivacaine provides effective anesthesia and superior postoperative analgesia compared with 0.5% lidocaine when forearm IVRA is used. Reg Anesth Pain Med 2002;27:595-599.

Comparison of mepivacaine and lidocaine for intravenous regional anaesthesia: pharmacokinetic study and clinical correlation

Limitations to the use of lidocaine for intravenous regional anaesthesia (IVRA) include lack of optimal intraoperative analgesia and systemic toxic reactions. This randomized double-blind study was conducted to compare intraoperative and postoperative analgesia, adverse effects, and plasma concentrations of mepivacaine or lidocaine, on release of the tourniquet in patients undergoing IVRA for distal upper limb surgery. Forty-two adult patients were randomly allocated to receive either a 0.5% lidocaine solution 3 mg kg(-1) (n=20) or mepivacaine 5 mg kg(-1) (n=22). Plasma concentrations of both anaesthetic agents were measured at 5, 10, 20, 30, 45, and 60 min after deflation of the tourniquet by gas chromatography. Although plasma concentrations of mepivacaine and lidocaine were comparable 5 min after deflation, concentrations of lidocaine decreased significantly thereafter, whereas plasma concentrations of mepivacaine were similar over the 60-min study period. Supplementary analgesia during the intraoperative period was required by 45% of patients in the lidocaine group as compared with 9% in the mepivacaine group (P=0.02). No adverse effects were observed in patients given mepivacaine. In the lidocaine group, adverse effects were observed in 10% of the patients. The total ischaemia time, volume of the local anaesthetic, and duration of the surgical procedure were not significantly different between the two groups. Mepivacaine 5 mg kg(-1) ensured better intraoperative analgesia than lidocaine 3 mg kg(-1) when used for IVRA. Plasma concentrations of lidocaine decreased significantly between 5 and 60 min following tourniquet deflation, whereas blood concentrations of mepivacaine remained below the toxic concentration.

Clonidine versus ketamine to prevent tourniquet pain during intravenous regional anesthesia with lidocaine

Background and Objectives: Both clonidine and ketamine have been found to prolong the action of local anesthetics through a peripheral mechanism. Our study compares the efficacy of a low dose of clonidine or ketamine separately added to intravenous regional anesthesia (IVRA) with lidocaine to prevent tourniquet pain. Methods: We conducted a prospective randomized double-blinded study in 45 patients undergoing hand or forearm surgery, with anticipated duration exceeding 1 hour under IVRA. Proximal cuff inflation of a double tourniquet was followed by administration of 40 mL of lidocaine 0.5% and either saline, 1 [mu ]g/kg clonidine, or 0.1 mg/kg ketamine. When anesthesia was established, the inflation of the proximal and distal cuff was interchanged. Thereafter, tourniquet pain was rated on a visual analog scale (VAS) every 10 minutes. Intraoperatively, boluses of 25 [mu ]g fentanyl were provided for tourniquet pain treatment when required, and total fentanyl consumption was recorded. Results: Patients receiving plain lidocaine persistently reported the highest pain scores among groups (P [lt ] .001) 20 minutes after distal cuff inflation. Differences between the groups with additional treatment were noted 50 minutes after distal cuff inflation and until the end of the observation, with significantly lower VAS ratings (P [lt ] .001 to P [lt ] .01) in ketamine-treated patients. Total fentanyl consumption was significantly decreased by ketamine (70.00 [plusmn] 25.35 [mu ]g) or clonidine (136.67 [plusmn] 39.94 [mu ]g) compared with the plain lidocaine group (215.33 [plusmn] 52.33 [mu ]g) (P [lt ] .001 between all groups). Conclusions: The addition of clonidine 1 [mu ]g/kg or ketamine 0.1 mg/kg to lidocaine for IVRA delays the onset of unbearable tourniquet pain and decreases analgesic consumption for tourniquet pain relief, although ketamine has a more potent effect. Reg Anesth Pain Med 2001;26:512-517.