The Analgesic Effect of Intravenous Neostigmine and Transdermal Nitroglycerine Added to Lidocaine on Intravenous Regional Anesthesia (Bier`s Block): A Randomized, Controlled Study in Hand Surgery

Marashi, Seyed Mojtaba; Yazdanifard, Arash; Shoeibi, Gita; Bakhshandeh, Hooman; Yazdanifard, Parin

doi:10.3923/ijp.2008.218.222

Cited by 4 publications

(2 citation statements)

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“…Using additives with lidocaine may provide satisfactory anaesthesia and prolong the duration of postoperative analgesia [1]. …”

Section: Introductionmentioning

confidence: 99%

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Does the Use of Nitroglycerin Patch Improve Local Anaesthetic Effects in Bier’s Block? A Double-Blind Placebo Controlled Study

Elgebaly

2018

Anesthesiology Research and Practice

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Aim The aim of the study was to assess the nitroglycerin patch as a new additive to Bier's block and its impact on the effects and dose of lidocaine. Methods Forty patients of each sex belonging to ASA I or II underwent elective tendon repair surgeries of the forearm and hand. The patients were divided into two equal groups as follows: Group C received only lidocaine (1.5 mg/kg, 0.25%) and Group N received lidocaine (1.5 mg/kg, 0.25%) + 5 mg transcutaneous nitroglycerin patch. Onset and recovery times for sensory and motor block, visual analogue scale (VAS) scores for bandage pain, postoperative VAS score, analgesic requirements, patients' satisfaction, and surgeons' opinion were recorded. Results Sensory block onset time was shorter in Group N (3.80 ± 1.0) than that in Group C (5.72 ± 1.46), and motor block onset time was shorter in Group N (10.72 ± 1.93) than that in Group C (13.56 ± 1.26). Sensory block recovery time was prolonged in Group N (10.56 ± 1.12) than Group C (6.88 ± 1.45), recovery time of motor block was prolonged in Group N (13.04 ± 1.57) than Group C (11.96 ± 1.72). Bandage pain had lower VAS scores in Group N. Postoperative VAS scores showed significant differences between both groups at the following points of measurement: 30 minutes, 1 hour, and 4 hours after bandage deflation. Postoperative analgesic effect was the longest in Group N (187.20 ± 60.79 min) than Group C (51.60 ± 25.28 min). Patients' satisfaction and surgeons' opinion were better in Group N than Group C. Conclusion Supplementation of Bier's block with transcutaneous nitroglycerin patch reduces the lidocaine dose, the sensory and motor block onset times, VAS scores, and analgesic consumption intra- and postoperatively. Length of the block recovery times for the sensory and motor effects, duration of postoperative analgesic effect, and the first time to analgesic requirement improved the quality of Bier's block with better patients' satisfaction and surgeons' opinion and had no adverse effects.

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“…Using additives with lidocaine may provide satisfactory anaesthesia and prolong the duration of postoperative analgesia [1]. …”

Section: Introductionmentioning

confidence: 99%

“…It is a reliable, simple, cost-effective, and widely accepted technique of regional anaesthesia [1]. …”

Section: Introductionmentioning

confidence: 99%

Does the Use of Nitroglycerin Patch Improve Local Anaesthetic Effects in Bier’s Block? A Double-Blind Placebo Controlled Study

Elgebaly

2018

Anesthesiology Research and Practice

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Approaches for breaking the barriers of drug permeation through transdermal drug delivery

Alexander

Dwivedi

AJAZUDDIN

et al. 2012

Journal of Controlled Release

443

238

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Comparison of clonidine and dexmedetomidine as adjuncts to intravenous regional anaesthesia

2015

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Background and Aims:Intravenous regional anaesthesia (IVRA) provides reliable and rapid analgesia with good muscular relaxation of the extremity distal to the tourniquet, but tourniquet pain and absence of post-operative analgesia are major drawbacks. α2 agonists, clonidine and dexmedetomidine are known to potentiate peripheral nerve blocks. The aim of this study was to compare clonidine and dexmedetomidine as adjuvants to IVRA with respect to block characteristics, tourniquet pain and post-operative analgesia.Methods:A prospective, randomised, double-blind study was conducted on 60 adult patients of American Society of Anesthesiologists physical status grades I and II, in two groups of 30 each, to receive either clonidine 1 μg/kg or dexmedetomidine 1 μg/kg added to 40 ml 0.5% preservative-free lignocaine. Independent samples t-test was used for analysing demographic data, haemodynamic data and block characteristics and Mann-Whitney U-test for skewed data.Results:Sensorimotor block onset was significantly faster and recovery delayed with dexmedetomidine as compared to clonidine. Intra-operative visual analogue scale (VAS) at 10 min, 15 min and 40 min and post-operative VAS at 30 min and 2 h were significantly higher with clonidine. Fentanyl consumption and sedation were comparable. Duration of analgesia was significantly longer with dexmedetomidine. Haemodynamic parameters were comparable.Conclusions:Dexmedetomidine significantly facilitates onset, prolongs recovery of sensory as well as motor block and also prolongs duration of analgesia as compared to clonidine. Both decrease tourniquet pain satisfactorily and have comparable intra-operative fentanyl requirement . Patient satisfaction is better with dexmedetomidine.

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The Analgesic Effect of Intravenous Neostigmine and Transdermal Nitroglycerine Added to Lidocaine on Intravenous Regional Anesthesia (Bier`s Block): A Randomized, Controlled Study in Hand Surgery

Cited by 4 publications

References 16 publications

Does the Use of Nitroglycerin Patch Improve Local Anaesthetic Effects in Bier’s Block? A Double-Blind Placebo Controlled Study

Does the Use of Nitroglycerin Patch Improve Local Anaesthetic Effects in Bier’s Block? A Double-Blind Placebo Controlled Study

Approaches for breaking the barriers of drug permeation through transdermal drug delivery

Comparison of clonidine and dexmedetomidine as adjuncts to intravenous regional anaesthesia

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