Intravenous Regional Anaesthesia in Hand Surgery — Experience with 632 Cases

Chan, Kkl; Ma, Gouveia; Chow, Yuk-Yin; Leung, P. C.

doi:10.1016/s0072-968x(81)80063-0

Cited by 7 publications

(3 citation statements)

References 9 publications

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“…Moreover, no specific anatomic knowledge is required. Bier's Block technique has been recommended as an alternative to general anesthesia for operations on the limbs, principally the upper limbs (12)(13)(14)(15). The recovery and cost of anesthesia using IVRA for outpatient hand surgery was half that of general anesthesia.…”

Section: Discussionmentioning

confidence: 99%

The Addition of Low-dose Mivacurium to Lidocaine for Intravenous Regional Anesthesia

Mızrak

Bozgeyik

Karakurum

et al. 2010

Journal of Musculoskeletal Pain

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Objectives: The current study aimed to evaluate low dosage of mivacurium added to lidocaine for intravenous regional anesthesia [IVRA].Methods: The present study used a double-blind methodology. The study group comprised 60 patients with the American Society of Anesthesiologists physical status I and II, who were scheduled to undergo carpal tunnel release as an outpatient procedure. Patients were randomly divided into two groups. In the mivacurium group [Group M; N = 30], intravenous regional anesthesia was achieved using 6 mg of mivacurium with lidocaine 3 mg/kg diluted with saline to a total volume of 40 ml; in the control group [Group C; N = 30] 3 mg/kg lidocaine was diluted with saline to a total volume of 40 ml. The onset and recovery time of sensory and motor blocks, intraoperative-postoperative visual analog scale, and verbal rating scale, tourniquet pain, satisfaction score, analgesic requirement, hemodynamic variables, and side effects were noted.Results: Group M showed significantly shorter sensory block and motor block onset time, longer motor block recovery time, and decreased analgesic requirement during the 24-hour postoperative period.Conclusions: Despite the longer motor block recovery, the addition of a low dose of mivacurium to lidocaine for IVRA accelerated the sensory and motor blocks onset and improved the postoperative analgesia without important perioperative adverse effects. We demonstrated that the addition of a low dose of mivacurium to lidocaine for IVRA provided a significant clinical benefit by shortening the sensory and motor blocks onset, providing sufficient muscle relaxation, and also reducing postoperative analgesic consumption without any serious adverse effects.

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Section: Discussionmentioning

confidence: 99%

The Addition of Low-dose Mivacurium to Lidocaine for Intravenous Regional Anesthesia

Mızrak

Bozgeyik

Karakurum

et al. 2010

Journal of Musculoskeletal Pain

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“…The results of this study show that in the large majority of cases IVRA is a perfectly satisfactory technique. This is also supported by the report of 632 satisfactory cases of hand surgery using IVRA recently presented by Chan et al (3). There are, however, many surgeons who regard the technique with a certain degree of scepticism just because of the problem of oozing.…”

Section: Discussionmentioning

confidence: 60%

Intravenous Regional Analgesia-A New Modification

Cox¹

1990

Survey of Anesthesiology

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A modification of the standard intravenous regional analgesia technique is described whereby excess local anaesthetic solution is removed from the veins of the isolated arm once analgesia has been established. This simple procedure was shown to reduce the incidence of oozing at the site of operation without affecting the quality of analgesia. Measurement of the quantity of local anaesthetic agent removed from the isolated arm 15 min after injection revealed that the amounts removed were small, indicating rapid uptake and binding in the tissues. This would imply that removal of excess local anaesthetic agent from the isolated arm aftrr 15 rnin does not confer added safety as regards reducing the risk of leakage of agent into the general circulation in the event of cuff failure.

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“…Chan 11 et al in 1981 described 632 patients also with no major complications but 7 minor reactions.…”

Section: Methodsmentioning

confidence: 98%