Comparison of Lidocaine and Prilocaine for Intravenous Regional Anesthesia

Bader, Angela M.; Concepción, Mercedes; Hurley, Ronald J.; Arthur, G. R.

doi:10.1097/00000542-198809000-00022

Cited by 45 publications

(23 citation statements)

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“…Bupivacaine is contraindicated because of poten tial cardiotoxicity, and fatal complications have been reported following intravenous injection (2-5), a situ ation which occurs with this technique when the tourniquet is released, The ideal agent for IVRA should achieve rapid onset of good surgical anesthesia and, above all, be safe. Lidocaine and ( ± )prilocaine both fulfil these criteria, as reported by several authors (7,(12)(13)(14)(22)(23)(24)(25)(26)(27)(28). The flushing and absorption of both lidocaine and prilocaine from the exsanguinated forearm after releas ing the tourniquet was so fast that the maximum plasma concentration was detected in the first sam pling time at 1 min The maximum plasma concen trations of lidocaine were in agreement with those reported earlier (9,29,30) and stayed well below the toxic concentrations of 5 -1 0 |lg/ml, depending on the degree of anaesthesia (31).…”

Section: Discussionsupporting

confidence: 69%

“…The method is safe provided a suitable local anaesthetic agent is used. Bupivacaine, for instance, is contra indicated because of its cardiotoxicity (2-5), Lidocaine and prilocaine are considered to be very suitable agents for IVRA (6)(7)(8)(9)(10)(11)(12)(13)(14). It is considered to be import ant for patients to leave hospital free of anaesthetic drugs (15,16).…”

Section: Intravenousmentioning

confidence: 99%

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Comparison of the disposition kinetics of lidocaine and ± prilocaine in 20 patients undergoing intravenous regional anaesthesia during day case surgery

Simon

Vree

Gielen

et al. 1997

Journal of Clinical Pharmacy and Therapeutics

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Results:The mean onset time of surgical analgesia of lidocaine was 11-2 ± 5*1 min and that of prilo caine was 10*9 ± 6 * 0 min. After releasing the tourniquet, lidocaine is bi-exponentially elim i nated with a tlj2a of 4*3 ± 2*1 min and a tlf2/} of 79*1 ± 31*2 min. Total body clearance was 0*86 dt 0*39 litres/min. Prilocaine is rapidly and bi-exponentially eliminated with a of 3*0 ± 1*6 min and a tll2^ o f 29-9 ± 1 5 * 7 min. The total body clearance of prilocaine is higher than that of lidocaine, 4*15 ± 1-31 vs. 0*86 ± 0*39 litres/min, respectively (P = 0*0007). Both compounds show comparable volum es of distribution (Fd, Vsa and Vp) and a comparable

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Section: Discussionsupporting

confidence: 69%

Section: Intravenousmentioning

confidence: 99%

Comparison of the disposition kinetics of lidocaine and ± prilocaine in 20 patients undergoing intravenous regional anaesthesia during day case surgery

Simon

Vree

Gielen

et al. 1997

Journal of Clinical Pharmacy and Therapeutics

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“…4 Lignocaine remains the standard Local Anaesthetic (LA) agent for surgical procedures in many countries, 5 and prilocaine is used widely in Europe. 6 Adverse effects of Bier's block are about LA toxicity, slow onset, poor muscle relaxation, tourniquet pain and minimal postoperative pain relief. The ideal drug for Bier`s block should have: rapid onset, reduced dose of LA, reduced tourniquet pain and prolonged post-op analgesia.…”

Section: Introductionmentioning

confidence: 99%

Co Mparative Evalution of Clonid I Ne With Lignocaine Versus Dexmedetomidine With Lignocaine in Bier’s Block

Pachore¹,

Chaudhari²,

Alapure³

et al. 2015

jemds

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Present study was conducted to compare the effects of adding clonidine vs dexmedetomidine to lignocaine in Bier`s block. It was prospective randomised double-blinded. 40 patients of ASA I or II posted for upper limb surgery under Bier`s block were included. Bier`s block was given with lignocaine with either dexmedetomidine 1μg/kg or clonidine 1μg/kg. There was no significant difference between the two groups in onset or regression of sensory and motor blockades. There was a significant decrease in number of patients requiring analgesia and its consumed amount in the Dexmedetomidine group (0% and 0μg, respectively) as compared to the Clonidine group (40% and 27±43μg, respectively) intraoperatively. There was a decrease in number of patients requiring analgesia and its consumed amount in Dexmedetomidine group (5% and 2.5±11μg, respectively) compared to the Clonidine group (35% and 32±24.5μg, respectively) post-operatively. The quality of anaesthesia was significantly better in Dexmedetomidine group than to Clonidine group. Patients were more sedated in the Dexmedetomidine group for brief post-operative period. This study concludes, adding dexmedetomidine to lignocaine in Bier`s block is more beneficial than adding clonidine.

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“…2 Lidocaine remains the standard local anesthetic (LA) agent for surgical procedures in North America 3 and prilocaine is used widely in Europe. 4 IVRA is simple to administer, reliable and cost-effective. 5 It is ideal for short operative procedures on the extremities performed on an ambulatory basis.…”

mentioning

confidence: 99%

A systematic review of adjuncts for intravenous regional anesthesia for surgical procedures

Choyce

Peng

2002

Can J Anesth/J Can Anesth

134

101

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Purpose: To review the use of adjuncts to intravenous regional anesthesia (IVRA) for surgical procedures in terms of their intraoperative effects (efficacy of block and tourniquet pain) and postoperative analgesia.Source: A systematic search (Medline, Embase, reference lists) for randomized, controlled and double-blinded studies using adjuncts to IVRA for surgical procedures was conducted. Data were collected on intraoperative effects (onset/offset and quality of block and tourniquet pain), postoperative effects (pain intensity and analgesic consumption) and side effects recorded. Statistical significance as indicated in the original report and likely clinical relevance were taken into account to arrive at a judgment of overall benefit.Principal findings: Twenty-nine studies met all inclusion criteria. Data on 1,217 study subjects are included. Adjuncts used were opioids (fentanyl, meperidine, morphine, sufentanil), tramadol, nonsteroidal anti-inflammatory drugs (NSAIDs; ketorolac, tenoxicam, acetyl-salicylate), clonidine, muscle relaxants (atracurium, pancuronium, mivacurium), alkalinization with sodium bicarbonate, potassium and temperature. There is good evidence to recommend NSAIDs in general and ketorolac in particular, for improving postoperative analgesia. Clonidine 1 µg·kg -1 also appears to improve postoperative analgesia and prolong tourniquet tolerance. Opioids are poor by this route; only meperidine 30 mg or more has substantial postoperative benefit but at the expense of postdeflation nausea, vomiting and dizziness. Muscle relaxants improve intraoperative motor block and aid fracture reduction. (fentanyl, mépéridine, morphine, sufentanil), le tramadol, les anti-inflammatoires non stéroïdiens (AINS; kétorolac, ténoxicam, acétylsalicylique), la clonidine, les myorelaxants (atracurium, pancuronium, mivacurium) Source : Une recherche systématique (bases de données Medline, Embase, listes de références) des études randomisées, contrôlées et à double insu utilisant les traitements d'appoint à l'ARIV pendant les interventions chirurgicales a été réalisée. Les données concernant les effets peropératoires ont été recueillies (début/fin et qualité du bloc et douleur de garrot) ainsi que les effets postopératoires (intensité de la douleur et consommation analgésique) et les effets secondaires. La signification statistique, tel qu'indiqué dans l'article original, et la pertinence clinique possible ont été retenues afin d'en arriver à un jugement sur les bienfaits généraux. Constatations principales : Vingt-neuf études répondaient à tous les critères d'inclusion. Les données sur 1 217 sujets d'étude ont été compilées. Les traitements d'appoint étaient des opioïdes

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Comparison of Lidocaine and Prilocaine for Intravenous Regional Anesthesia

Cited by 45 publications

References 0 publications

Comparison of the disposition kinetics of lidocaine and ± prilocaine in 20 patients undergoing intravenous regional anaesthesia during day case surgery

Comparison of the disposition kinetics of lidocaine and ± prilocaine in 20 patients undergoing intravenous regional anaesthesia during day case surgery

Co Mparative Evalution of Clonid I Ne With Lignocaine Versus Dexmedetomidine With Lignocaine in Bier’s Block

A systematic review of adjuncts for intravenous regional anesthesia for surgical procedures

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