Anesthésie locorégionale intraveineuse

Estèbe, Jean-Pierre

doi:10.1016/s0750-7658(99)80154-3

Annales Françaises d'Anesthésie et de Réanimation

1999

DOI: 10.1016/s0750-7658(99)80154-3

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Anesthésie locorégionale intraveineuse

Jean-Pierre Estèbe

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Cited by 4 publications

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“…Intravenous regional anaesthesia (IVRA) is a simple and effective technique for distal upper limb surgery of less than 1 h duration. 1 Some clinical studies have recently shown that the addition of a non-steroidal anti-in¯ammatory agent, 2 an opioid, 3 neuromuscular blocking agents, 4 clonidine, 5 and even ketamine 6 to lidocaine can improve the quality of the regional anaesthesia. Although lidocaine is one of the least toxic local anaesthetics, in our experience, limitations to its use include lack of optimal intraoperative analgesia and systemic toxic reactions.…”

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confidence: 99%

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

Prieto-Alvarez

Calas-Guerra

Fuentes-Bellido

et al. 2002

British Journal of Anaesthesia

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confidence: 99%

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

Prieto-Alvarez

Calas-Guerra

Fuentes-Bellido

et al. 2002

British Journal of Anaesthesia

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A modification of the inter-cuff technique of IVRA for use in knee arthroscopy

Al-Metwalli

Mowafi

2002

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : To describe a modified approach to intravenous regional anesthesia (IVRA) for operations on the knee joint.C Cl li in ni ic ca al l f fe ea at tu ur re es s: : A 52-yr-old male presenting for knee arthroscopy was anesthetized by IVRA using only 40 mL of lidocaine 0.5%. After performing IVRA in the routine way an additional below knee tourniquet was used and inflated after local anesthetic exsanguination towards the knee. Operation was performed without the need for further analgesic.C Co on nc cl lu us si io on n: : The technique allowed the use of a small anesthetic volume for IVRA on the lower limb, thus decreasing the potential risk of local anesthetic toxicity. NTRAVENOUS regional anesthesia (IVRA) is a reliable and efficient technique with a lower cost than general anesthesia and well adapted for limb surgery in the ambulatory patient. 1,2 The use of potentially unsafe large doses of local anesthetic made the technique unpopular for operations on the lower extremity. 3 We describe a case of knee arthroscopy that was performed successfully under IVRA using 40 mL of 0.5% lidocaine isolated between two tourniquets applied above and below the knee. ObjectifC Ca as se e r re ep po or rt t A man aged 52 yr weighing 78 kg presented for arthroscopy of the knee joint. He had pain and swelling of the left knee. Preoperative orthopedic examination showed mild genu vara, knee crepitation and synovial thickening. Knee x-ray showed advanced osteoarthritic changes more on the patello-femoral articulation and medial compartment of the knee joint.On the preanesthetic visit the patient requested a regional technique and gave no history of medical problems except previous multiple level lumbar disc surgery. The proposed IVRA technique, which had been approved by the departmental Ethical Committee, was fully explained to him and his consent was taken. The patient was given 10 mg diazepam orally 90 min before surgery.The patient was placed on the operating table. An iv access was secured in the right forearm and routine monitors were applied. A double cuffed tourniquet was arranged over a soft padding above the knee joint and an 18-G plastic cannula was inserted on the dorsum of the foot (Figure 1a). The lower limb was exsanguinated with a rubber bandage (Figure 1b).The tourniquet was then inflated to 270 mmHg which is 100 mmHg above the limb occlusive pressure (LOP) as determined by photoplethysmograpic pulse wave

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