Comparison of two different doses of dexmeditomidine to prevent tourniquet pain during intravenous regional anaesthesia with lidocaine
Journal Title: MedPulse -International Medical Journal - Year 2017, Vol 4, Issue 1
Abstract
Background and Objectives: Intravenous regional anaesthesia (IVRA) has been used for more than a century. Dexmeditomidine has found to prolong the action of the action of local anaesthetics through a peripheral mechanism. Our study compares the efficacy of two different doses (0.5mic/kg and 1mic/kg) of dexmeditomidine added to IVRA with lidocaine to prevent tourniquet pain. Study design: A prospective, randomized, double-blind study. Methods: This study was carried out in 60 normotensive, ASA grade I and II patients, aged 18 to 60 years who were scheduled for elective orthopedic forearm and hand surgeries under intravenous regional anaesthesia (IVRA). The patients were divided into two groups of 30 each. Group I received 40ml of 0.5% lidocaine and 0.5 mic/kg dexmeditomidine after proximal cuff inflation. Group II received 40ml of 0.5% lidocaine and 1 mic/kg dexmeditomidine after proximal cuff inflation. When anaesthesia was established, the distal cuff inflated and proximal cuff deflated. Time of onset and offset of sensory and motor blocks, and time to tourniquet pain were recorded. Postoperative VAS score, time to first rescue analgesic were recorded. Results: The onset times of both sensory and motor blocks were shortened in group II as compared to group I. Prolonged sensory - motor recovery times, prolonged tolerance time for tourniquet were found in group II. Significantly lower postoperative VAS scores, longer time to first postoperative rescue analgesic were recorded in group II. Conclusion: Addition of 1 mic/kg dexmeditomidine to lidocaine for IVRA delays the onset of unbearable tourniquet pain and increases time to first rescue analgesic in the postoperative period as compared to 0.5 mic/kg dexmeditomidine.
Authors and Affiliations
Basappa M Diwanmal, Prashant A Lomate, Ravikiran Thote
Keywords
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