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

Kumar, Alok; Sharma, DK; Datta, Barun

doi:10.4103/0970-9185.101941

Cited by 26 publications

(32 citation statements)

References 15 publications

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“…These results are in accordance with the result of these studies. 20 Gupta A in 2014 conducted a study with two different doses of dexmedetomidine as an adjunct to lignocaine in IVRA of upper limb surgeries and concluded that addition of 1µg/kg of dexmedetomidine to lignocaine for IVRA improves quality of anaesthesia and post-operative analgesia in comparison to 0.5µg/kg of dexmedetomidine. 21 The mean total rescue analgesic consumption in the form of doses in both the groups were noted during intra-operative and post-operative period.…”

Section: Discussionmentioning

confidence: 99%

Comparative Evaluation of Adding Clonidine v/S Dexmedetomidine to Lignocaine During Bier’s Block in Upper Limb Orthopedic Surgeries

Chatrath¹,

Sharan²,

Ranjana³

et al. 2014

jemds

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BACKGROUND AND AIMS: Intravenous regional anaesthesia is used for short procedures for upper limb and hand surgery. IVRA with adjuvants like opioids, NSAIDS, muscle relaxants increases the efficacy in terms of analgesic duration and quality of anaesthesia. We conducted this study for evaluation of adding clonidine with dexmedetomidine during bier's block in upper limb orthopedic surgeries. MATERIAL AND METHODS: Sixty patients of American society of anaesthesiologist (ASA) class I, II, III patients undergoing upper limb surgeries were enrolled. IVRA was established using 3mg/kg of 0.5% lignocaine diluted with saline to a total volume of 40ml to which 1µg/kg of clonidine in group I or 1µg/kg dexmedetomidine in group II was added. The sensory block and motor block onset and recovery, hemodynamic parameters sedation score, VAS score, doses of analgesic requirement, patient satisfaction score, surgeon satisfaction score were noted and recorded at 15min, 30min, 1hr, 2hr, 3hr, 12hr and 24hr time interval. RESULTS: Both like groups were comparable with respect to age, sex, weight, ASA grade, baseline hemodynamic vitals, duration of surgery and intra-operative and post-operative hemodynamic variables. Sensory block onset and recovery was 4.85 ±0.49 min and 5.9±0.66 min in group II (LD). Motor block onset and recovery was 10.91±0.6 min and 6.83±0.69 min in group I (LC) and 11.2±0.59 min and 7.13±0.57 min respectively in group II (LD). CONCLUSION: The addition of 1µg/kg of clonidine or 1µg/kg or 1µg/kg of dexmedetomidine to 3mg/kg of 0.5% of lignocaine is found to be effective, comparable in terms of onset and recovery of sensory and motor blockade, hemodynamically stable and without any side effects and complications.

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Section: Discussionmentioning

confidence: 99%

Comparative Evaluation of Adding Clonidine v/S Dexmedetomidine to Lignocaine During Bier’s Block in Upper Limb Orthopedic Surgeries

Chatrath¹,

Sharan²,

Ranjana³

et al. 2014

jemds

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“…In this study, ketamine decreased the block beginning time, delay in tourniquet pain, and reduced the need for analgesics after surgery [21].…”

Section: Discussionmentioning

confidence: 99%

Comparing the Analgesic Effects of Lidocaine and Lidocaine with Ketamine in Intravenous Regional Anesthesia on Postoperative Pain

Yaghubi¹,

Rashtchi²,

Karamitanha³

2016

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Background and purpose:The main and the most known complication of intravenous regional anesthesia (IVRA) is systemic toxicity due to local anesthetics that occurs following the accidental tourniquet release immediately after injection. This study aims to evaluate the effect of adding ketamine to lower dose of lidocaine on reducing the dose and side effects of lidocaine. Materials and Methods: In this randomized clinical trial, 60 patients undergoing the surgery of upper limb below the elbow under IVRA were randomly divided into two groups. In group 1 (control group), 40 ml lidocaine 0.5% (200 mg) and in group 2 (intervention group), 40 ml lidocaine 0.25% (100 mg) plus 40 mg of ketamine 0.1% injected intravenously. Outcomes included postoperative pain at 15, 30 and 60 minutes after surgery. The pain of the patients was assessed by using the Visual Analogue Scale (VAS Score). Results: Both groups were comparable in demographic and surgical parameters. The average pain based on the VAS score at 15, 30 and 60 minutes after surgery was similar in both groups and there was no significant difference between the two groups (p> 0.05). Moreover, postoperative complications including unconsciousness, restlessness, dizziness, nausea, vomiting, tinnitus, seizure, delirium and hallucination had no significant differences (p> 0.05). Conclusion: Results of this study showed that the addition of ketamine to lower dose of lidocaine in patients receiving IVRA significantly reduced postoperative pain, and reduces the likelihood of systemic toxicity with lidocaine without causing significant adverse effects.

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“…RİVA yönteminin dezavantajları, mutlaka turnike gerektirir olması ve buna bağlı olarak ameliyat süresinin turnike süresi ile sınırlı olmasıdır (4). RİVA'da yeterli anestezi sağlamak için kullanılan lokal anestezik hacminin yüksek olması ve turnike açılmasını takiben analjezinin kısa sürede sonlanması gibi dezavantajları nedeniyle, girişimin etkinliğini ve postoperatif analjeziyi artırmak ve turnike ağrısını ortadan kaldırmak için lokal anesteziklere çeşitli adjuvan ilaçlar (opioidler, nonsteroid antienflamatuar ilaçlar, nöromusküler blokerler, neostigmin, magnezyum, sodyum bikarbonat ve klonidin) eklenmektedir (4 (9,10). Adjuvan ilaçlar ile anestezi derinliğinin arttırılması, anestezi süresinin uzaması, hemodinaminin daha stabil olması ve peroperatif oluşabilecek komplikasyonların azaltılması amaçlanmıştır (11,12,13).…”

Section: Introductionunclassified

“…RİVA'nın etkisi, turnike indirilmesini takiben geçtiği için postoperatif ağrı kontrolüne yardımcı bir yöntem değildir. Adjuvan ilaçların kullanılmaya başlamasıyla birlikte, literatürde turnike indirildikten sonra hissedilen ağrının azaldığına dair raporlara rastlanmaya başlamıştır (9,8,14). Adjuvan ilaç olarak ketamin ve deksmedetomidinin karşılaştırıldığı bir çalışmada, 72 hasta kontrol grubuyla beraber üç grupta incelenmiş ve duyusal ve motor blok başlangıç ve derlenme süreleri, turnike indirildikten sonraki ağrı derecesi, ilk analjezik ihtiyacı zamanı ve yan etkiler kayıt edilmiştir.…”

Section: Introductionunclassified

“…Duyusal ve motor blok başlama zamanlarının ketamin kullanılan grupta daha kısa sürdüğü, postoperatif analjezik ihtiyacının da deksmedetomidinin kullanılan grupta daha geç başladığı görülmüştür. Bununla birlikte her iki grupta da, plasebo kullanılan gruba göre, turnike indirildikten sonra saptanan ağrı derecesi daha düşük bulunmuştur (9). Kalsiyum iyonu, lokal anesteziklerin analjezik etkisinde önemli bir role sahiptir.…”

Section: Introductionunclassified

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Rejyonal İntravenöz Anestezi̇de Li̇dokai̇n İle Li̇dokai̇n Ve Magnezyum Kombi̇nasyonunun Karşilaştirilmasi

et al. 2015

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Objectives: RIVA (Regional Intravenous Anesthesia) is frequently preferred during distal upper extremity operations (hand, wrist and forearm) compared to general anesthesia because of the following reasons: lower operational cost, simplicity, surgical operation environment stability, quick implementation and faster recovery time. Deeper anesthesia, prolonged effective time, hemodynamic stabilization, reduced intraoperative complications and longer postoperative analgesia are aimed by using adjunct drugs. Main objective of our study is to investigate the effectiveness of magnesium as an adjunct in RIVA. Material & Methods:A set of 18-80 year old patients who were operated on upper extremity using RIVA at Istanbul University, Istanbul Medical Faculty, Department of Orthopedics between 2012 and 2013 were evaluated retrospectively for this study. Only adult subjects who are classified with ASA I and II preoperative physical condition were included. Patients were evaluated according to BMI (Body Mass Index), gender, ASA score, anesthesia success rate, hemodynamic stabilization, VAS (Visual Analogue Scale) score at 1st postoperative hour and for emergent adverse effects. Results: 40 RIVA patients were included in this study. 20 patients were anaesthetized using Magnesium (Group-M) and the other 20 patients were anaesthetized without using Magnesium (Group-K). No statistical differences were determined between the groups regarding demographic data. Comparison of hemodynamic parameters between Group-M and Group-K showed no significant difference (p<0,05). It is observed that VAS score comparisons do not indicate

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

Cited by 26 publications

References 15 publications

Comparative Evaluation of Adding Clonidine v/S Dexmedetomidine to Lignocaine During Bier’s Block in Upper Limb Orthopedic Surgeries

Comparative Evaluation of Adding Clonidine v/S Dexmedetomidine to Lignocaine During Bier’s Block in Upper Limb Orthopedic Surgeries

Comparing the Analgesic Effects of Lidocaine and Lidocaine with Ketamine in Intravenous Regional Anesthesia on Postoperative Pain

Rejyonal İntravenöz Anestezi̇de Li̇dokai̇n İle Li̇dokai̇n Ve Magnezyum Kombi̇nasyonunun Karşilaştirilmasi

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