Comparison of Lornoxicam and Fentanyl when added to Lidocaine in Intravenous Regional Anesthesia

Sertöz, Nezih; Kocaoğlu, Nazan; Ayanoğlu, Hilmi Ömer

doi:10.1016/j.bjane.2012.07.001

Cited by 5 publications

(5 citation statements)

References 11 publications

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“…These adverse effects should be given due consideration prior to its use as an adjunct. For intravenous regional anaesthesia, NSAIDs mixed with local anaesthetic is established practice and findings indicate benefits such as reduced onset and prolonged analgesia for several combinations including: lidocaine with lornoxicam [118–120]; lidocaine with ketorolac [121]; and prilocaine with lornoxicam [122], ketorolac or lysine acetylsalicylic acid [123]. The use of NSAIDs as an adjunct has also gained popularity for local infiltration analgesia and intra‐articular injection as there is some evidence of a clinically‐relevant peripheral analgesic action.…”

Section: Resultsmentioning

confidence: 99%

Section: Anaesthetic Adjunctsmentioning

confidence: 99%

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Pharmacological and clinical implications of local anaesthetic mixtures: a narrative review

Nestor

Sepúlveda

et al. 2021

Anaesthesia

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Summary Various techniques have been explored to prolong the duration and improve the efficacy of local anaesthetic nerve blocks. Some of these involve mixing local anaesthetics or adding adjuncts. We did a literature review of studies published between 01 May 2011 and 01 May 2021 that studied specific combinations of local anaesthetics and adjuncts. The rationale behind mixing long‐ and short‐acting local anaesthetics to hasten onset and extend duration is flawed on pharmacokinetic principles. Most local anaesthetic adjuncts are not licensed for use in this manner and the consequences of untested admixtures and adjuncts range from making the solution ineffective to potential harm. Pharmaceutical compatibility needs to be established before administration. The compatibility of drugs from the same class cannot be inferred and each admixture requires individual review. Precipitation on mixing (steroids, non‐steroidal anti‐inflammatory drugs) and subsequent embolisation can lead to serious adverse events, although these are rare. The additive itself or its preservative can have neurotoxic (adrenaline, midazolam) and/or chondrotoxic properties (non‐steroidal anti‐inflammatory drugs). The prolongation of block may occur at the expense of motor block quality (ketamine) or block onset (magnesium). Adverse effects for some adjuncts appear to be dose‐dependent and recommendations concerning optimal dosing are lacking. An important confounding factor is whether studies used systemic administration of the adjunct as a control to accurately identify an additional benefit of perineural administration. The challenge of how best to prolong block duration while minimising adverse events remains a topic of interest with further research required.

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Section: Resultsmentioning

confidence: 99%

Section: Anaesthetic Adjunctsmentioning

confidence: 99%

Pharmacological and clinical implications of local anaesthetic mixtures: a narrative review

Nestor

Sepúlveda

et al. 2021

Anaesthesia

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“…Reducing pain and need for analgesics by enhancing the quality of anesthesia is one of the main goals in patients undergoing IVRA. For this purpose, clinical studies have been performed by adding various agents such as dexamethasone [ 10 ], midazolam [ 11 ], diltiazem [ 12 ], dexmedetomidine [ 13 ], paracetamol [ 14 ], lornoxicam [ 15 , 16 ], nitroglycerine [ 17 ], magnesium [ 18 ], and ketamine [ 19 ], to the local anesthetic solution and the search for the agent that would provide the most appropriate outcome with the least side effect is ongoing. In the present study, the effects of addition of tramadol to lidocaine were evaluated.…”

Section: Discussionmentioning

confidence: 99%

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

Yektaş

Gümüş

Karayel

et al. 2016

Anesthesiology Research and Practice

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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 survey in North American showed that 11% of anesthesiologists added other drugs to lidocaine for IVRA ( 8 ). These additives are: NSAID, opioids, muscle relaxants, clonidine, and magnesium sulfate ( 9 - 12 ). However, just regarding NSAID especially ketolorac, there is good evidence to use as an additive for improving postoperative pain control after IVRA ( 13 ).…”

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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Comparison of Lornoxicam and Fentanyl when added to Lidocaine in Intravenous Regional Anesthesia

Cited by 5 publications

References 11 publications

Pharmacological and clinical implications of local anaesthetic mixtures: a narrative review

Pharmacological and clinical implications of local anaesthetic mixtures: a narrative review

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

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

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