DOI: 10.36347/sjams.2015.v03i03.014

Pages: 1103-1106

Intravenous regional anesthesia (IVRA) is widely recommended and applied in patients undergoing ambulatory procedures on the hand with various additives to improve block quality and reduced tourniquet pain. However, there is no report in literature of the use of pethidine when using lidocaine based IVRA with single tourniquet on the forearm for hand surgery. This double blind, randomized study was conducted to compare and evaluate the effect of adding pethidine as an adjunct to lidocaine during IVRA with single tourniquet application to forearm. After obtaining approval from the Ethical Issues Committee, 60 ASA I or II patients of either sex between age range of 18-60 yr undergoing elective hand surgery of less than 60 minutes duration and giving their verbal consent for IVRA were included in the study. Patients were randomly divided into two groups of 30 patients each. Group L patients received 2.5 mg/kg 2% lidocaine while Group LP received 2.5 mg/kg 2 % lidocaine + pethidine (0.15 mg/kg) in the arm with a single tourniquet placed in the distal 3rd of the forearm. For any intraoperative breakthrough of pain, fentanyl 0.5µg/Kg was administered up to maximum of two doses. If pain remains unrelieved, general anesthesia was to be administered. Patient and surgeon satisfaction was noted to be significantly improved by the addition of pethidine to lidocaine and it also resulted in significant reduction of intraoperative requirement of fentanyl (p=0.004) with an insignificant prolongation of sensory block after the release of tourniquet.