Adding Dexmedetomidine to Lidocaine for Intravenous Regional Anesthesia

Abstract

This study was designed to evaluate the effect of dexmedetomidine when added to lidocaine for IV regional anesthesia. This is the first clinical study demonstrating that the addition of 0.5 microg/kg dexmedetomidine to lidocaine for IV regional anesthesia improves quality of anesthesia and intraoperative-postoperative analgesia without causing side effects.

Intravenous dexmedetomidine, but not midazolam, prolongs bupivacaine spinal anesthesia

“…Memiş et al 8 reported that the addition of 0.5 lg Á kg -1 dexmedetomidine to lidocaine for intravenous regional anesthesia shortened sensory and motor block onset times and prolonged sensory and motor block recovery times without causing side effects. Coşkuner et al 7 have shown that intravenous administration of dexmedetomidine might prolong the recovery time of the sensory blockade of bupivacaine-induced sensorial blockade during epidural anesthesia.…”

“…[1][2][3] Also, it has been used safely as premedication or as a sedative agent in patients undergoing surgical procedures under regional anesthesia. 4,5 Although a synergistic interaction between intrathecal dexmedetomidine and local anesthetics has been observed in previous studies, [6][7][8][9] there are no clinical data regarding the effect of intravenous dexmedetomidine premedication on the duration of sensory and motor block during spinal anesthesia.…”

The analgesic effect of three different doses of nitroglycerine when added to lidocaine for intravenous regional anesthesia in trauma patients

“…[1,3] Different additives such as opioids, tramadol, nonsteroidal antiinflammatory drugs, dexmedetomidine, and muscle relaxant have been combined with LAs to improve block quality, prolong post-deflation analgesia and decrease tourniquet pain. [1,3,4] Sen and colleagues [5] showed that the addition of 200 µg nitroglycerine (NTG) to lidocaine for IVRA improves sensory and motor block, tourniquet pain and postoperative analgesia without side effects. They emphasized that more studies with different doses must be performed to determine a relevant conclusion before the routine use of NTG.…”

“…[1][2][3][4]29] NTG may possibly cause dose-dependent side effects such as hypotension, tachycardia or headache as well. [27] In the present study, there was no significant difference in side effects between groups.…”

The Efficacy of Adding Lornoxicam-Dexmedetomidine to 0.25% Diluted Lidocaine for Intravenous Regional Anesthesia

“…However, accidental intraoperative release of tourniquet or deliberate postoperative release of tourniquet may cause convulsions, coma, cardio-respiratory depression and even cardiac arrest at this high dose [3]. Anesthetists attempted many modified techniques of IVRA to use a lesser dose of lidocaine combined with some adjuvants to avoid these side effects; NSAIDs, paracetamol, [4][5][6] ketamine, [7] opioids, [8] α-2 adrenergic receptor agonists, [9] and dexaethasone [10] have been added to abolish the tourniquet pain and to provide longer postoperative analgesia.…”