Addition of Dexmedetomidine or Lornoxicam to Prilocaine in Intravenous Regional Anaesthesia for Hand or Forearm Surgery

Kol, İclal Özdemir; Öztürk, Hayati; Kaygusuz, Kenan; Gürsoy, Sinan; Comert, Baris; Mimaroğlu, Caner

doi:10.2165/0044011-200929020-00006

Cited by 26 publications

(30 citation statements)

References 29 publications

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“…Kol et al in a prospective, randomized, double-blinded study of 75 patients scheduled for hand or forearm surgery found that the addition of dexmedetomidine (0.5 mg/kg) to prilocaine improved the quality of anesthesia and decreased analgesic requirement as determined by hemodynamic variables and pain scores, lengthened the duration of analgesia, and decreased total analgesic consumption over the first 24 postoperative hours. 12 Similar results were reached by Memis et al in their prospective study of 30 patients undergoing hand surgery using IVRA. 13 The patients were randomly assigned to receive IVRA with lidocaine only or lidocaine with dexmedetomidine (0.5 mg/kg).…”

Section: Discussionsupporting

confidence: 74%

Dexmedetomidine Controls the Hemodynamic Manifestations of Tourniquet Pain

Allee¹,

Muzaffar

Tobias³

2011

American Journal of Therapeutics

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Dexmedetomidine is an α2-adrenergic agonist that is Food and Drug Administration-approved for the provision of short-term (less than 24 hours) sedation of adults during mechanical ventilation. Given its beneficial physiological effects, including sedation and anxiolysis, various applications have been reported in the perioperative period. We report the use of dexmedetomidine to control the hemodynamic consequences of tourniquet pain in three patients having either orthopedic or plastic surgical procedures requiring the use of tourniquets. In all cases, dexmedetomidine controlled the hemodynamic responses to tourniquet pain, including tachycardia and hypertension. The use of dexmedetomidine in this scenario is discussed, and its potential advantages over other agents, including opioids, are reviewed.

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Section: Discussionsupporting

confidence: 74%

Dexmedetomidine Controls the Hemodynamic Manifestations of Tourniquet Pain

Allee¹,

Muzaffar

Tobias³

2011

American Journal of Therapeutics

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“…[1617] Addition of dexmedetomidine to prilocaine in IVRA decreases pain scores, improves anesthesia quality, decreases analgesic requirement, shortens sensory block onset time, and prolongs sensory block recovery time. [618] Addition of dexmedetomidine to lignocaine in IVRA also improves the quality of anesthesia and decreases the analgesic requirements but has no effect on the sensory and motor block onset and regression time. [6] Our study demonstrated that the addition of dexmedetomidine, in dose of one mcg/kg of body weight, to lignocaine for IVRA not only improved quality of anesthesia and postoperative analgesia without causing significant side effects but also shortened the onset of sensory and motor block as compared to placebo.…”

Section: Discussionmentioning

confidence: 99%

Addition of ketamine or dexmedetomidine to lignocaine in intravenous regional anesthesia: A randomized controlled study

Kumar¹,

Sharma²,

Datta³

2012

J Anaesthesiol Clin Pharmacol

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Introduction:Ketamine and dexmedetomidine decrease anesthetic requirement and provide analgesia to patients. We designed this study to compare the effect of dexmedetomidine and ketamine when added to lignocaine in intravenous regional anesthesia (IVRA).Materials and Methods:Seventy two patients undergoing hand surgery were randomly assigned to three groups to receive IVRA. They received 20 ml of 1% lignocaine and either 1 ml of isotonic saline (Group L, n = 24); or 0.5 mg/kg body weight ketamine (Group LK, n = 24) or 1 mcg/kg body weight dexmedetomidine (Group LD, n = 24). Sensory and motor block onset and recovery time were noted. After the tourniquet deflation, pain and sedation values, time to first analgesic requirement and any side effects were noted.Results:Shortened sensory and motor block onset times (69.17 min and 7.83 min respectively, P < 0.0001) and improved quality of anesthesia (satisfaction score = 3, P < 0.05) were found in ketamine group. Visual analog scale scores (3.21 ± 0.41) were comparable while time to first analgesic requirement (166.25 ± 25.89 min, P < 0.0001) was significantly longer in dexmedetomidine group after tourniquet release.Conclusion:We conclude that the addition of 1 mcg/kg of body weight dexmedetomidine or 0.5 mg/kg of body weight ketamine to lignocaine for IVRA improves quality of anesthesia and perioperative analgesia without causing side effects. We considered ketamine reduced the time for onset of block, delayed the onset of tourniquet pain, and reduced postoperative analgesic requirement and had a better patient satisfaction than placebo or dexmedetomidine.

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“…The enhanced onset of sensory and motor blockade have been attributed to the raising of the PH of the local anesthetic solution by adding lornoxicam. Kol et al [15] used lornoxicam with prilocaine for IVRA, their study showed longer sensory and motor block recovery times, prolonged analgesia and tourniquet tolerance times and decreased the 24 h analgesic requirements in the group with lornoxicam. Jankovic et al [16] studied the effect of adding ketorolac and dexamethasone to lidocaine IVRA on the postoperative analgesia and tourniquet tolerance for ambulatory hand surgery; they attributed that the analgesic properties of NSAIDs to their antioxidant properties.…”

Section: Discussionmentioning

confidence: 97%

“…Iclal O et al [20] added either dexmedetomidine or lornoxicam to IRA for upper limb surgeries and found that both of them provided good analgesic and anaesthetic quality without causing adverse effects as no hypotension, bradycardia or hypoxia requiring treatment was seen in any of the patients. Also Ramadhyani U et al [21] proved that the addition of dexmedetomidine to IVRA solutions improved postoperative analgesia as well as decreased the total local anesthetic dose.…”

Section: Discussionmentioning

confidence: 99%