Fentanyl and lidocaine versus lidocaine for Bier block.
OBJECTIVE
The present study was designed to assess the efficacy of fentanyl combined with dilute lidocaine solution for intravenous regional anesthesia of the arm.


METHODS
In ten volunteers, the nondominant arm was exposed to three treatments: 100 mg lidocaine, 42 ml; 100 mg lidocaine plus 100 micrograms fentanyl, 42 ml; and 100 micrograms fentanyl, 42 ml. Each subject was tested on three occasions with three or more days between experiments. Sensory and motor function was tested to determine whether the neural effects of the particular treatments differed.


RESULTS
When lidocaine and lidocaine plus fentanyl results were compared, no significant differences were found. However, anesthesia, analgesia, and loss of motor function generally were less complete and slower in onset with the fentanyl alone treatment. Two subjects became nauseated after tourniquet cuff deflation when lidocaine plus fentanyl was tested, as did one subject when fentanyl was tested.


CONCLUSIONS
Results of this and other studies indicate there is no value in adding fentanyl to local anesthetics for intravenous regional anesthesia.
Arthur
J M
JM
Department of Anesthesiology, Texas Tech University Health Sciences Center, Lubbock 19430.
Heavner
J E
JE
Mian
T
T
Rosenberg
P H
PH
D000328:Adult; D000765:Anesthesia, Conduction; D000771:Anesthesia, Intravenous; D001132:Arm; D005283:Fentanyl; D006801:Humans; D008012:Lidocaine; D008297:Male
D008012:Lidocaine; D005283:Fentanyl