Abstract

A COMPARATIVE STUDY OF THE EFFECTS OF DIFFERENT DRUGS USED TO SUPPLEMENT THE LOCAL ANESTHETIC IN INTRAVENOUS REGIONAL ANESTHESIA (BIER'S BLOCK) FOR SURGICAL PROCEDURES OF THE UPPER LIMB

*Dr. Trifa Assadlah Faidlah and Ali Mohammed Kareem

ABSTRACT

Background: block) is used for anesthesia for surgical procedures on the upper limb, it is a reliable, simple and safe method for providing anesthesia with low incidence of side effects. It is recommended as an alternative to general anesthesia for operations on the hands, forearms and arms. An intravenous cannula is inserted, the limb is exsanguinated, a tourniquet applied and the veins filled with local anesthetic. Intravenous regional anesthesia (Bier's Objective: To perform the intravenous regional anesthesia by using minimal dose of local anesthetic (lidocaine) with additive drugs (dexamethasone, atracurium) to decrease the toxicity of lidocaine and improve the quality of anesthesia, analgesia and muscle relaxation perioperatively. Study design: This study is clinical trials comparative study. Setting: This study was performed in Teaching and Emergency Hospitals in Sulimani city eriod of January 2007 to September 2007, it is approved by Suliamani Ethical mittee. uk a Laas ASA I and II status, average ages of 18-65 years of both gender were omly into three groups, thirty patients in each group, neither prepared nor me measures: ents the onset of action, time to motor and sensory recovery and gesia were measured, comparison among them is done and the epain intensity scale was evaluated. sults shows that the addition of (8 mg) dexamethasone to lidocaine 1e to sensory recovery and perioperative analgesia in group B (12.48 + is longer than in group A (plane lidocaine) (11.55 + 1.35, 52.50 ess than0.05). nonstrates that the addition of (1 mg) of atracurium to lidocaine n (complete motor and sensory block) in group C (4.40 + soup A (4.99 + 0.13) (p value is less than 0.05), while the 4 perioperative analgesia in group A (14.06 + 0.79, 52.50 5 + 1.66, 50.8 + 13.6) (p value is more0.05) Conclusions: It is concluded that the addition of (8 mg) of dexamethasone to supplement a“ intravenous regional anesthesia is advisable to improve the quality of anesthesia an in provide better perioperative analgesia and the addition of a minimum dose of atracurium (1 mg) will speed the onset of action, provide good intraoperative muscle relaxation and optimize the operative condition with minimizing the potential toxicity of the local anesthetic.

Keywords: Bier's block, simple descriptive pain intensity scale, dexamethasone and atracurium.