Intravenöse Regionalanästhesie an Arm und Fuß mit 0,5-, 0,75- und 1,0prozentigem Prilocain

Abstract

Intravenous Regional Anaesthesia (TVRA) for Surgery of the Arm and Foot with 0.5, 0.75-, and 1.0% Prilocaine Summary Qualtity of anaesthesia and risk of intoxication are competing principles in IVRA. To evaluate the optimal prilocaine concentration with injection of 40 ml, 300 patients were randomly allocated to receive either a 0.5 (PM 0.5), 0.75 (PRI 0.5) or a 1.0 (PR1 1.0) per Cent solution. Using PFU 0.5, fifteen patients required supplementary fentanyl, with PRI 0.75 one, and with PRi 1.0 two (p I 0.05). General anaesthesia proved necessary in three patients of the PRI 0.5 and 0.75 groups, respectively, and in one patient of the PFU 1.0 group (NS). With PR1 1.0 seven patients had subjective signs of intoxication upon tourniquet release, with PRI 0.75 none, and with PR1 0.5 one (p I 0.05). Objective symptoms of local anaesthetic toxicity were not observed. The incidence of tourniquet-related pain was 25-30% in all three groups and not related to the prilocaine concentration. In conclusion, with 4 0 ml injection volume the 0.75% solution of prilocaine offers the optimal relation between incidence of anaesthesia and risk of intoxication. ZusammenfassungBei der IVRA treten mit Steigerung der Ge-

Differentialindikation zentraler und peripherer Leitungsanästhesien

“…Bei einem Injektionsvolumen von 40 ml bietet Prilocain 0,75% das beste Verhältnis von Erfolgsquote und dem Risiko für eine Intoxikation [39]. Bei einem Injektionsvolumen von 40 ml bietet Prilocain 0,75% das beste Verhältnis von Erfolgsquote und dem Risiko für eine Intoxikation [39].…”