Effects of Addition of Systemic Tramadol or Adjunct Tramadol to Lidocaine Used for Intravenous Regional Anesthesia in Patients Undergoing Hand Surgery

Intravenous regional anesthesia (IVRA) is used in outpatient hand surgery as an easily applicable and cost-effective technique with clinical advantages. The present study aimed to investigate the effects of addition of systemic tramadol or adjunct tramadol to lidocaine for IVRA in patients undergoing hand surgery. American Society of Anesthesiologists (ASA) I-II patients (n=60) who underwent hand surgery were included. For this purpose, only lidocaine (LDC), lidocaine+adjunct tramadol (LDC+TRA group), or lidocaine+systemic tramadol (LDC+SysTRA group) was administered to the patients for IVRA and the groups were compared in terms of onset and recovery time of sensory and motor blocks, quality of anesthesia, and the degree of intraoperative and postoperative pain. The onset time of sensorial block was significantly shorter in the LDC+TRA group than that in the LDC+SysTRA group. The motor block recovery time was significantly shorter in the LDC+SysTRA group than that in the LDC+TRA and LDC groups. Administration of tramadol as an adjunct showed some clinical benefits by providing a shorter onset time of sensory and motor block, decreasing pain and analgesic requirement, and improving intraoperative conditions during IVRA. It was determined that systemic tramadol administration had no superiority.

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A COMPARATIVE STUDY OF TWO DIFFERENT DOSES OF DEXMEDETOMIDINE AS ADJUNCT TO LIDOCAINE IN INTRAVENOUS REGIONAL ANESTHESIA

Wiadomości Lekarskie ◽

10.36740/wlek202109203 ◽

2021 ◽

Vol 74 (9) ◽

pp. 2259-2264

Author(s):

Diana Salam Sami ◽

Ali Hadi Muslih

Keyword(s):

Regional Anesthesia ◽

Motor Block ◽

Onset Time ◽

Sensory Block ◽

P Value ◽

Intravenous Regional Anesthesia ◽

Group 3 ◽

Group 2 ◽

Different Doses ◽

Group 1

The aim: To compare the different doses of dexmedetomidine as adjuvant to lidocaine in intravenous regional anesthesia. Materials and methods: Ninety patients participated in this study in Al-Yarmook teaching hospital in period between January 1st 2016 – July 1st 2016, divided randomly in to 3 groups. Group 1: received lidocaine diluted with normal saline; Group 2 – lidocaine with dexmedetomidine 0.5 μg/kg; Group3 -lidocaine with dexmedetomidine 1 μg/kg. Statistical analysis was done by IBM SPSS program version 20 and Microsoft excel version 2010 , the means were compared by ANOVA methods and Dunnett t3, significancebetween groups were recorded if p value less than 0.05. Results: Dexmedetomidine was effective in decreasing the sensory block onset time and motor block onset time and prolongation of the motor and sensory recovery with no significant hemodynamic changes than is often shown by the lidocaine alone, it also prolongs the time interval for analgesic requirement after the operation. For the group 3 it was faster than in group 2 and faster than in group 1 significantly (p value < 0.001) to form a sensory block onset and motor block onset; and it took significantly more time to recover the sensation than in group 1 (p value <0.001) and 2 (p value <0.002) , and more time for motor recovery than in group 1 (p value < 0.001). Group 3 had the longest time to call for the analgesia after operation than group 2 and 3 (p value < 0.001); and group 2 also had longer time for the same process than group 1 (p value < 0.001). Conclusions: A variety of adjuvants have been used in IVRA to decrease tourniquet pain, improve block quality, and prolong analgesia after cuff deflation. Opioids are relatively ineffective and cause nausea, vomiting, and dizziness after tourniquet deflation, but several NSAIDs have been shown to be beneficial, dexmedetomidine improves block quality and postoperative analgesia.

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Peri- and Postanalgesic Properties of Lidokain, Lornoxicam, and Nitroglycerine Combination at Intravenous Regional Anesthesia

BioMed Research International ◽

10.1155/2014/737109 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Biricik Melis Cakmak ◽

Gokhan Cakmak ◽

Elif Akpek ◽

Gulnaz Arslan ◽

Mehmet Sukru Sahin

Keyword(s):

Regional Anesthesia ◽

Recovery Time ◽

Motor Block ◽

Sensory Block ◽

Study Groups ◽

The Other ◽

Lidocaine Group ◽

Tourniquet Pain ◽

Intravenous Regional Anesthesia ◽

Vas Scores

Background.This study was conducted to compare and evaluate the effect of adding lornoxicam or nitroglycerine as adjuncts to lidocaine in intravenous regional anesthesia (IVRA).Methods.60 patients were randomly separated into three groups, lidocaine group (group L), lidocaine + lornoxicam group (group LL), and lidocaine + lornoxicam + transdermal nitroglycerine group (group LL-N). Hemodynamic parameters, sensory and motor blocks onset, and recovery times were recorded. Analgesic consumption for tourniquet pain and postoperative period were recorded.Results.Sensory block onset times and motor block onset times were shorter in the LL-N and LL groups compared with L group. Sensory block recovery time and motor block recovery time were prolonged in the LL and LL-N groups compared with group L. The amount of fentanyl required for tourniquet pain was less in group LL and group LL-N when compared with group L. VAS scores of tourniquet pain were higher in group L compared with the other study groups. Postoperative VAS scores were higher for the first 4 hours in group L compared with the other study groups.Conclusion.The adjuvant drugs (lornoxicam or TNG) when added to lidocaine in IVRA were effective in improving the overall quality of anesthesia, reducing tourniquet pain, increasing tourniquet tolerance, and improving the postoperative analgesia.

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Analgesic Effect of Nalbuphine When Added to Intravenous Regional Anesthesia: A Randomized Control Trial

January 2018 - Pain Physician ◽

10.36076/ppj/2016.19.575 ◽

2016 ◽

Vol 8;19 (8;11) ◽

pp. 575-581

Author(s):

Sayed Kaoud Abd-Elshafy

Keyword(s):

Postoperative Pain ◽

Adverse Events ◽

Regional Anesthesia ◽

Recovery Time ◽

Onset Time ◽

Controlled Clinical Trial ◽

University Hospitals ◽

Double Blind ◽

Intravenous Regional Anesthesia ◽

Cortisol Levels

Background: Different adjuvant drugs are currently added to lidocaine for intravenous regional anesthesia (IVRA) to decrease tourniquet and postoperative pain. Objective: The aim of the study was to examine the effect of nalbuphine when added to IVRA. Study Design: Prospective, randomized, double-blind, controlled clinical trial. Setting: Assiut University Hospitals. Methods: One hundred-six adult patients scheduled for unilateral hand surgery under IVRA were randomized into 2 equal groups. The lidocaine-nalbuphine (LN) group received nalbuphine plus lidocaine and the lidocaine (L) group received lidocaine. A tourniquet and postoperative pain were assessed using a visual analogue scale (VAS). The following parameters were measured: onset and recovery time for both sensory and motor blocks, intra- and postoperative analgesic consumption, time to first analgesic request, postoperative nausea and/or vomiting (PONV), hemodynamics, and cortisol levels. Results: Early tourniquet and postoperative pain were significantly lower in the LN group. The onset time for both sensory and motor blocks was significantly shorter in the LN group. In addition, the recovery time for both sensory and motor blocks was longer in the LN group. Intra- and postoperative fentanyl consumption was significantly lower in the LN group with no significance in postoperative diclofenac consumption. The patient first analgesic request was significantly delayed in the LN group (P < 0.0001). There were no significant differences between the 2 groups in PONV, hemodynamic parameters abnormalities, medications adverse events or cortisol levels. Limitations: The inclusion of a study group in which the nalbuphine administered systemically could determine whether its beneficial effects were due to its local or systemic action. Conclusions: Nalbuphine decreases early tourniquet and postoperative pain after IVRA and delays the need for analgesic rescue. In addition, nalbuphine accelerates the onset and prolongs the recovery time for both sensory and motor blocks with no significant adverse events. However, it has no effect on postoperative cortisol levels. Key words: Intravenous, regional anesthesia, lidocaine, nalbuphine, pain, postoperative

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