Simple Arm Tourniquet as an Adjunct to Double-Cuff Tourniquet in Intravenous Regional Anesthesia

Jafarian, Ali; Imani, Farnad; Salehi, Reza; Mazaher, Farid Najd; Moini, Fatemeh

doi:10.5812/aapm.29316

Cited by 6 publications

(6 citation statements)

References 18 publications

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“…Local anesthesia is a safe and effective method in different surgeries such as upper extremity surgeries ( 1 ). This approach has several advantages over general anesthesia including lack of pain during operation, decreased postoperative pain and analgesic dose, more hemodynamic stability, and increased patients satisfaction ( 2 - 4 ). Supraclavicular brachial plexus block is a common method in forearm surgeries ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

The Effect of Adding Dexmedetomidine as an Adjuvant to Lidocaine in Forearm Fracture Surgeries by Supraclavicular Block Procedure Under Ultrasound-Guided

et al. 2018

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BackgroundTo improve the brachial plexus block (BPB) performance, different compounds have been used as adjuvants to local analgesics.ObjectivesThe aim of the present study was to investigate the effects of adding DEX to lidocaine on effectiveness of nerve block, and postoperative pain in forearm fracture surgery by supraclavicular BPB undergoing ultrasound-guided.MethodsThis was a double-blinded randomized clinical trial conducted on 72 patients with ASA classes I and II, which were candidates for forearm fracture surgery. In group A, patients received 3 mg/kg of lidocaine 2%. In group B, patients received 3 mg/kg of lidocaine 2% and DEX (1 µg/kg). The ultrasound-guided supraclavicular BPB was performed in all patients. The onset of sensory and motor blocks were evaluated with pin prick test and modified Bromage scale, respectively. The sensory and motor block moment was recorded as the onset of the block. The first analgesic request time, total consumed analgesic, adverse effect, and hemodynamic parameters of patients were recorded. A visual analog scale (VAS) was used for recording the severity of pain.ResultsThe two groups showed no significant difference in the demographic variables. The onset of sensory and motor block in the DEX groups was shorter. The duration of sensory and motor block, and analgesic request was significantly longer than the control groups. Total analgesic consumption 24 hours after surgery in the DEX groups was significantly lower. Moreover, hemodynamic status of patients in both groups was stable and no significant difference was observed between groups. This study showed that DEX, as an adjuvant to lidocaine, improve the characteristics of supraclavicular BPB and decrease the postoperative pain.

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Section: Introductionmentioning

confidence: 99%

The Effect of Adding Dexmedetomidine as an Adjuvant to Lidocaine in Forearm Fracture Surgeries by Supraclavicular Block Procedure Under Ultrasound-Guided

et al. 2018

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“…Intravenous regional anesthesia (IVRA) is a simple type of regional anesthesia that has many advantages such as: reliability, effectiveness, economic for day care, and safe for emergency surgery when patient is full stomach ( 1 - 4 ). However, it has some limitations such as lack of postoperative analgesia, tourniquet pain, insufficient muscle relaxation, and local anesthetic toxicity ( 5 , 6 ).…”

Section: Introductionmentioning

confidence: 99%

Comparison of Magnesium Sulfate and Tramadol as an Adjuvant to Intravenous Regional Anesthesia for Upper Extremity Surgeries

et al. 2017

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BackgroundIntravenous Regional Anesthesia (IVRA) is a simple efficient method for providing regional anesthesia of the limbs. However, it has some limitations such as lack of postoperative analgesia.ObjectivesThis study aimed to compare the analgesic effects of magnesium sulfate and tramadol when added to lidocaine used for IVRA in upper limb surgery.MethodsIn this double - blind randomized clinical trial, 69 patients who underwent elective upper limb surgery with IVRA were randomly allocated into 3 groups. Patients in group A, received IVRA with 0.5% lidocaine and tramadol 100 mg, in group B received IVRA with 0.5% lidocaine and magnesium sulfate 1.5 g, while in group C patients received IVRA with 0.5% lidocaine and normal saline. The onset of sensory block and the duration of postoperative analgesia pain intensity were noted in each patient. Furthermore, the incidence of postoperative nausea and vomiting, respiratory depression, and skin rash were recorded.ResultsDuration of postoperative analgesia was more prolong in the tramadol group than other groups (P = 0.01). Also, the total amount of morphine consumption in the group A, group B, and C was 8.91 ± 5.81, 11.95 ± 4.81, 16.72 ± 4.07 mg, respectively, which was significantly lower in the tramadol group in comparison to the other groups (P = 0.01).ConclusionsIt seems that adding tramadol as an adjuvant to lidocaine during IVRA in comparison to magnesium sulfate increases duration of postoperative analgesia and decreases analgesic consumption without increasing opioid-related side effects.

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“…In the study of Jafarian et al ( 19 ), a modified Bier's block method versus the traditional one performed on patients undergoing surgery of upper limb bones showed considerable pain relief at surgical and tourniquet sites during the operation until one hour thereafter. In another study by Jafarian et al ( 20 ), pneumatic arm tourniquet as an adjunct to intravenous regional anesthesia (IVRA) provided acceptable analgesia, especially in the elderly, although it needs to be more considered in future studies. However, it should be noted that it is technically more difficult and time-consuming for emergencies.…”

Section: Discussionmentioning

confidence: 99%

Hematoma Block Versus General Anesthesia in Distal Radius Fractures in Patients Over 60 Years in Trauma Emergency

et al. 2016

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BackgroundDistal radius fractures are among common fractures in the elderly. Regarding the age, background diseases, and possible risks, analgesia method is of great importance in this group.ObjectivesThe aim of this study was to compare two analgesia methods including hematoma block and general anesthesia in people over 60 years in the orthopedic emergency department.Methods68 elderly patients referring to the emergency department of a medical teaching center were selected based on the inclusion criteria for a non-randomized clinical trial. The patients were placed in two groups of 34, which were matched for age and sex. Hematoma block was used as the analgesic method in one group and general anesthesia was used in the other group. These two groups were compared for pain intensity, analgesia duration, and anesthesia side effects. The SPSS software (Statistical Package for the Social Sciences, version 17.0, SPSS Inc., Chicago, Ill, USA) was used for data analysis.Results68 elderly patients (mean age of 70.3 ± 6.6) with a dislocated distal radius fracture which required closed reduction were examined. The duration of manipulation and surgery and discharging time were significantly different between two groups and they were all lower in the hematoma blocked group. Pain intensity evaluation indicated a statistically significant difference during initial hours after fracture reduction and fixation so that pain intensity was less in elderly patients under hematoma block than patients who underwent general anesthesia in one and six hours after surgery. Need for narcotic was 35.2% in the general anesthesia group which also showed a significant between-group difference.ConclusionsHematoma block analgesia used in distal radius fractures of the elderly is a very safe and effective method that seems preferable to general anesthesia in emergency departments.

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Simple Arm Tourniquet as an Adjunct to Double-Cuff Tourniquet in Intravenous Regional Anesthesia

Cited by 6 publications

References 18 publications

The Effect of Adding Dexmedetomidine as an Adjuvant to Lidocaine in Forearm Fracture Surgeries by Supraclavicular Block Procedure Under Ultrasound-Guided

The Effect of Adding Dexmedetomidine as an Adjuvant to Lidocaine in Forearm Fracture Surgeries by Supraclavicular Block Procedure Under Ultrasound-Guided

Comparison of Magnesium Sulfate and Tramadol as an Adjuvant to Intravenous Regional Anesthesia for Upper Extremity Surgeries

Hematoma Block Versus General Anesthesia in Distal Radius Fractures in Patients Over 60 Years in Trauma Emergency

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