Improvement in i.v. regional anaesthesia by re-exsanguination before surgery.
A modification of an i.v. regional anaesthesia (IVRA) technique is described in which the arm is re-exsanguinated before surgery (re-IVRA). IVRA and re-IVRA were compared for quality of operative field, sensory and motor block, quality of analgesia and blood concentrations of prilocaine, lignocaine and mepivacaine in a double-blind study in 120 patients undergoing hand surgery. Re-IVRA provided a significantly better surgical field without affecting sensory or motor block. Re-exsanguination improved tolerance of the tourniquet. Plasma concentrations in the re-IVRA group showed some increases, but these were not in the toxic range.
Rawal
N
N
Department of Anaesthesia, Orebro Medical Center Hospital, Sweden.
Hallén
J
J
Amilon
A
A
Hellstrand
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000765:Anesthesia, Conduction / Q000379:methods*; D000771:Anesthesia, Intravenous / Q000379:methods*; D001132:Arm / Q000098:blood supply*; D016063:Blood Loss, Surgical / Q000517:prevention & control; D004311:Double-Blind Method; D005260:Female; D006225:Hand / Q000601:surgery; D006489:Hemostatic Techniques; D006801:Humans; D008012:Lidocaine; D008297:Male; D008619:Mepivacaine; D008875:Middle Aged; D011318:Prilocaine; D014111:Tourniquets
D011318:Prilocaine; D008012:Lidocaine; D008619:Mepivacaine