title: Use of a simple forearm tourniquet as an adjunct to an intravenous regional block.
abstract: Intravenous regional anesthesia (IVRA) is a well-recognized technique for producing anesthesia during surgical procedures of the extremities. It has been suggested that the application of a tourniquet to the forearm may improve the quality of the block. The purpose of this investigation was to determine whether the application of a forearm tourniquet would accelerate onset time and improve the density and quality of an intravenous regional block. Twenty volunteer subjects were enrolled and randomly assigned in this crossover investigation. Control subjects received a standard IVRA technique; experimental subjects received IVRA technique with the application of a simple forearm tourniquet. Pain was elicited by means of an electrical stimulus, and assessments were performed using a 100-mm Visual Analogue Scale (VAS). Paired t tests were used to examine differences between groups on the variables studied. It was noted that the arm with the tourniquet had a shorter time for the onset of anesthesia (P = .0008) and had lower 10-minute VAS tolerance (P = .0469). This investigation suggests that the application of a simple forearm tourniquet as an adjunct to IVRA provides a more rapid onset of anesthesia than when no tourniquet is applied and may improve the density and quality of the block.
authors.affiliation: Department of Anesthesiology, Naval Medical Center, San Diego, Calif., USA.
authors.forename: Roger
authors.initials: R
authors.lastname: Davis
authors.forename: John
authors.initials: J
authors.lastname: Keenan
authors.forename: Alex
authors.initials: A
authors.lastname: Meza
authors.forename: Patrick
authors.initials: P
authors.lastname: Danaher
authors.forename: Charles
authors.initials: C
authors.lastname: Vacchiano
authors.forename: R Lee
authors.initials: RL
authors.lastname: Olson
authors.forename: John
authors.initials: J
authors.lastname: Maye
mesh_terms: D000328:Adult; D000765:Anesthesia, Conduction / Q000295:instrumentation* / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage; D005260:Female; D005542:Forearm; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D009719:Nurse Anesthetists; D014111:Tourniquets
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine