Abstract:Intravenous regional block is the anesthetic technique created by A. K. G Bier exactly 100 years ago. In the first half of the 20th Centuty, it evolved little and slowly, but in the last several years, it has seen an accentuated improvement, thanks to countless technical, pathophysiological, pharmacological, pharmacokinetic, and clinical developments, for which Brazilian Anesthesiology has contributed considerably. Since it is celebrating its 100th anniversary in 2008, intravenous regional block deserves to ha… Show more
“…With Bier block, it has been shown that after tourniquet release a significant portion of the local anesthetic remains in the operated limb for a prolonged time. 20 When performing surgery with a tourniquet, there is a 10-to 15-minute time frame between ropivacaine infiltration and restoration of the blood flow. During this period, systemic absorption is absent and postponed until the time of deflation.…”
“…With Bier block, it has been shown that after tourniquet release a significant portion of the local anesthetic remains in the operated limb for a prolonged time. 20 When performing surgery with a tourniquet, there is a 10-to 15-minute time frame between ropivacaine infiltration and restoration of the blood flow. During this period, systemic absorption is absent and postponed until the time of deflation.…”
“…Intravenous regional anesthesia (IVRA) is used in outpatient hand surgery as an easily applicable and cost-effective technique with clinical advantages and it is an ideal anesthetic method particularly for short lasting procedures [ 1 ]. Although IVRA has a history more than a century old, it has regained importance in the recent years as an effective and safe technique [ 2 ]. Nevertheless, IVRA has some disadvantages including anesthetic toxicity, slow-onset, poor muscle relaxation, tourniquet pain, and minimal postoperative pain relief [ 3 ].…”
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.
“…Intravenous regional anesthesia (IVRA) is mainly used in surgical operations with predicted durations of <1 h. Although this technique is useful for fractures of the upper extremity, especially distal to the elbow, and relieves the need for general anesthesia, it is limited by pain resulting from the application of tourniquets and postoperative pain ( 1 – 3 ). Increasing the efficacy of pain control in IVRA has been attempted by several authors, who have studied the addition of drugs, such as dexmedetomidine, dexamethasone, ketorolac and melatonin, to lidocaine in IVRA protocols, and reported enhanced anesthesia time and reduced pain perceived by patients ( 4 – 7 ).…”
Intravenous regional anesthesia (IVRA) is useful during short surgeries, but is not effective against pain due to tourniquet applications or postoperative pain. Several attempts have been made to identify a useful technique that can be coadministered with IVRA to reduce postoperative and tourniquet-related pain. The present study represents one such attempt, in which the authors combined IVRA with low-level laser therapy and assessed the effects on pain following surgical fixation of distal radial fractures.
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