Author/Authors :
Jahangiri Fard Alireza نويسنده Anesthesiologist, Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD) ,Shahid Beheshti University of Medical Science, Tehran, Iran , Babaee Touraj نويسنده Rajaie Cardiovascular Medical and Research Center, Tehran University of Medical Sciences, Tehran, IR Iran , Mahjoubifard Maziyar نويسنده Department of Anesthesiology, Fellowship in Cardiac
Anesthesiology, Children and Adolescents’ Health Research Center,
Zahedan University of Medical Sciences, Zahedan, IR
Iran , Enayati Hasan نويسنده Deoartment of Anesthesiology, Children and Adolescents’
Health Research Center, Zahedan University of Medical Sciences,
Zahedan, IR Iran , Heidari Mehdi نويسنده Deoartment of Anesthesiology, Children and Adolescents’
Health Research Center, Zahedan University of Medical Sciences,
Zahedan, IR Iran
Abstract :
Background: Intravenous regional anesthesia (IVRA) (or Bier’s
block) is the administration of a local anesthetic drug to an organ
intravenously, when compressed by tourniquet. Simple use in outpatient
and emergency settings, being regional instead of general anesthesia and
having reasonable costs make IVRA most acceptable. Objectives:
Nitroglycerine, as a safe and available medication, was evaluated by the
current study in the search for better analgesia withlower complications
that plays the role of a suitable adjuvant in regional anesthesia by
lidocaine. Patients and Methods: Through a randomized controlled
clinical trial, two types of anesthesia were used regionally for 70
cases of forearm surgery between 2010 and 2011. Elective cases of
forearm surgery with American Society of Anesthesiologist (ASA) class I
or II were enrolled in the study and were randomly divided to two groups
of cases and controls. For the control group, lidocaine was used alone
for IVRA while for the intervention group lidocaine as well as 200 µg of
nitroglycerin was used through the procedure. Results: On average,
sensory block started in 3.48 and 6.5 minutes, for the case and control
groups, respectively. The mean motor block time was 4.18 and 6.98
minutes for the cases and controls, respectively. The groups differed in
terms of times required for sensory and motor blocks. Recovery time was
longer among cases (118.32 ± 7.8 minutes) when compared to the controls.
Conclusions: Nitroglycerin at a dose range between 200 and 400 µg, as an
adjunct for lidocaine, can evidently improve regional anesthesia,
increase block recovery time and postpone the need for postoperative
analgesics, especially opioids.
