Addition of cisatracurium to lidocaine for intravenous regional anesthesia

Esmaoğlu, Aliye; Akın, Aynur; Mızrak, Ayşe; Turk, Yildirim; Boyacı, Adem

doi:10.1016/j.jclinane.2005.08.003

Cited by 14 publications

(29 citation statements)

References 24 publications

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“…Para-lyzing the arm with atracurium has been shown to facilitate fracture reduction, reduce pain during and after the procedure, and may obviate the need for general anesthesia and hospital admission (9,21). Similarly, Esmaoglu et al (10) reported that 0.01 mg/kg of cisatracurium added to lidocaine in IVRA improves the quality of anesthesia, shortens sensory and motor blocks onset time, and reduces postoperative analgesic requirements without adverse clinical effects. The probable mechanism of cisatracurium is suggested as the blockage of the function of motor end plate before the appearance of upper extremity ischemia in IVRA (22).…”

Section: Discussionmentioning

confidence: 99%

“…McGlone, Heyes, and Harris (9) had demonstrated that the addition of atracurium to prilocaine for Bier's Block technique was safe in clinical practice. Esmaoglu, Akin, Mizrak, Turk, and Boyaci (10) reported that the addition of cisatracurium to lidocaine in IVRA shortened the sensory and motor blocks onset time, improved the quality of anesthesia, and reduced analgesic requirements.…”

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confidence: 99%

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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%

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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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“…26,27 The addition of a small dose of neuromuscular blocking agent to the local anaesthetic during IVRA has been shown to decrease the pain experienced by the patient, both during and after the procedure. 19,[27][28][29] Cisatracurium may therefore reduce propofol injection pain via blockade of peripheral nerve endings by direct diffusion of the local anaesthetic from the vessels into the nearby nerves, followed by blockade of nerve trunks at a proximal site. 30 The findings of the present study indicate a possible pharmacological method to prevent pain from propofol injection, and show that cisatracurium is an acceptable alternative to lidocaine, opioids, ketamine, NSAIDs or other drugs used for this purpose.…”

Section: Discussionmentioning

confidence: 99%

“…The addition of cisatracurium (a nondepolarizing neuromuscular blocking drug) to lidocaine has been shown to improve the quality of analgesia during IVRA. 19 We therefore hypothesized that tourniquet-controlled pretreatment with cisatracurium could reduce propofol injection pain. To our knowledge, there are no studies that report the characteristics of propofol injection pain following cisatracurium pretreatment.…”

Section: Introductionmentioning

confidence: 99%

Cisatracurium pretreatment with tourniquet reduces propofol injection pain: A double-blind randomized controlled trial

2014

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Objectives: To investigate the efficacy of pretreatment with cisatracurium for prevention of pain associated with propofol injection, and compare its efficacy with that of lidocaine. Methods: Patients undergoing general anaesthesia were randomized to receive normal saline (control group), lidocaine (0.5 mg/kg), 0.03 mg/kg cisatracurium or 0.15 mg/kg cisatracurium. All drugs were administered into the largest dorsal vein of the hand with venous occlusion for 30 s, followed by propofol (0.5 mg/kg). Pain was evaluated using a four-point scale.Results: The incidence and severity of pain was significantly lower in the lidocaine and 0.15 mg/kg cisatracurium groups than the control and 0.03 mg/kg cisatracurium groups (n ¼ 50/group). There was no significant difference between the lidocaine and 0.15 mg/kg cisatracurium groups in the incidence and severity of pain. Conclusions: 0.15 mg/kg cisatracurium effectively decreases the incidence and severity of pain induced by propofol injection without any significant complications.

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“…In the studies carried on RIVA, efforts have been exerted to improve the quality of anesthesia by adding several adjuvant substances to local anesthetics [5–7, 16, 17]. We also added NaHCO 3 to prilocaine in our study and planned to investigate the effects on the tourniquet pain and the onset and termination times of motor and sensory blocks.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Effects of Low Volume Prilocaine and Alkalinized Prilocaine for the Regional Intravenous Anesthesia Technique in Hand and Wrist Surgery

Kapusuz¹,

Argun²,

Arıkan

et al. 2014

BioMed Research International

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Aim. Comparing the effectivity of prilocaine and prilocaine alkalinized with 8.4% NaHCO3 in terms of sensory and motor block onset and termination durations in RIVA technique considering patients' satisfaction and tolerance with application of tourniquet undergoing hand-wrist surgery. Materials and Methods. 64 patients were randomised into two groups. First group (Group P) was administered prilocaine and second group (Group PN) was administered prilocaine + %8.4 NaHCO3. Sensory and motor block onset and termination times and onset of tourniquet pain were recorded. Results. No significant difference was found between the two groups in terms of onset and termination of sensory block and the onset of motor block. The duration of the motor block was longer in Group PN than in Group P (P < 0.05). Tourniquet pain was more intense in Group P (P = 0.036). In Group PN, the use of additional drugs was recorded at a lower rate and patients' satisfaction was higher than Group P. Conclusion. In the present study, it was established that alkalinization of prilocaine had no effect on the duration of sensory block and it prolonged the duration of motor block, increased patients' satisfaction, and decreased tourniquet pain. It is our suggestion that future studies should be carried out on the issue by using different volumes.

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Addition of cisatracurium to lidocaine for intravenous regional anesthesia

Cited by 14 publications

References 24 publications

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

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

Cisatracurium pretreatment with tourniquet reduces propofol injection pain: A double-blind randomized controlled trial

Comparison of the Effects of Low Volume Prilocaine and Alkalinized Prilocaine for the Regional Intravenous Anesthesia Technique in Hand and Wrist Surgery

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