title: Comparison of two different anesthesia techniques for tourniquet pain with the use of forearm tourniquet.
abstract: OBJECTIVE
  The purpose of this prospective, randomized study was to compare the effectiveness of two different anesthesia techniques for tourniquet pain in minor surgeries of the hand with the use of the forearm tourniquet.
  
  
  METHODS
  In group 1, the area under the tourniquet was anesthetized circumferentially using a cream composed of 5% lidocaine and 5% prilocaine (Emla Astra). In group 2, the area under the tourniquet was anesthetized with a ring-type infiltration of the skin and subcutaneus tissues using 50% diluted Citanest solution using 22 G x 3 1/2'' size spinal needle (Sujia) with three injections.
  
  
  RESULTS
  There were no statistically significant differences between the means of the two groups with respect to both tests (p value = 0.18 [t-test], p = 0.951 [Mann-Whitney test]). Tourniquet related anesthesia technique discomfort was higher in group 2 (p = 0.001).
  
  
  CONCLUSIONS
  The tourniquet placed at the distal forearm is an effective, safe, and useful technique for hand surgery. Anesthesia using Emla cream is equally effective and less disturbing than using the injection technique (subcutaneus ring anesthesia).
authors.affiliation: Department of Orthopaedic Surgery, T.C.S.B. Ankara Occupational Diseases Hospital, Keçiören, Ankara, Turkey. drsermetinal@yahoo.com
authors.forename: Sermet
authors.initials: S
authors.lastname: Inal
authors.forename: Mehmet
authors.initials: M
authors.lastname: Er
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ozsoy
authors.forename: Ali
authors.initials: A
authors.lastname: Cavusoglu
authors.forename: Veysel
authors.initials: V
authors.lastname: Dincel
authors.forename: Abdurrahman
authors.initials: A
authors.lastname: Sakaogullari
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000758:Anesthesia / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D005542:Forearm; D006225:Hand / Q000601:surgery*; D006801:Humans; D007279:Injections, Subcutaneous; D008012:Lidocaine / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009824:Ointments; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D011318:Prilocaine / Q000008:administration & dosage / Q000627:therapeutic use; D011446:Prospective Studies; D014111:Tourniquets / Q000009:adverse effects*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D009824:Ointments; D011318:Prilocaine; D008012:Lidocaine