Title: ADDITION OF PANCURONIUM AND NITROGLYCERIN TO LIDOCAINE FOR INTRAVENOUS REGIONAL ANESTHESIA IN UPPER EXTREMITY SURGERY: BLOCK CHARACTERISTICS AND POSTOPERATIVE ANALGESIA
Abstract: Background: Intravenous regional anesthesia (IVRA) provides reliable and rapid analgesia with good muscle relaxation of the extremity distal to the tourniquet, but tourniquet pain and absence of post-operative analgesia are major drawbacks. Nitroglycerine and muscle relaxants are known to potentiate peripheral nerve blocks. Objective: Comparing nitroglycerine and pancuronium as adjuvants to IVRA with respect, block characteristics, and post- operative analgesia. Patient and Methods: This study was carried out in Al- Azhar University Hospitals for 6 months ( from 1/4/2016 to 1/10/2016 ) on 60 patients of both sexes aged 20-50 years, and belonging to ASA I & II undergoing forearm and hand surgeries. Patients were randomely divided into three equal groups ( 20 patients at each group ) . Group I received 40 cc of 3 mg/kg of lidocaine diluted in normal saline (0.9 % NaCl), Group II recieved 40 cc of 1.5 mg/kg of lidocaine diluted in normal saline (0.9% NaCl) with 200 µg nitroglycerine, and Group III received 40 cc of 1.5 mg/kg of lidocaine diluted in normal saline (0.9 % NaCl with 200 µg nitroglycerin and 0.5 mg pancuronium. Results: Group I has the slowest sensory and motor onset time, but the shortest sensory and motor recovery time. There was no significant difference between Group II and III as regarding sensory onset and recovery times, but Group III has shoter motor onset time and more prolonged motor recovery time than Group II. As regard postoperative analgesic requirements, Group II and III needed less analgesic doses than Group I, but there was no significant difference between Group II and III. Conclusion: Addition of 0.5 mg pancuronium and 200 µg nitroglycerin as adjuvant to lidocaine for intravenous regional anesthesia reduced the dose of lidocaine used for IVRA, shortened the sensory and motor block onset times, prolonged the sensory and motor block recovery times, and reduced the postoperative analgesic requirement and improved the quality of intravenous regional anesthesia with no side effects.
Publication Year: 2017
Publication Date: 2017-07-01
Language: en
Type: article
Indexed In: ['crossref']
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