LIDOCAINE AND FENTANYL WITH DISTAL FOREARM INTRAVENOUS REGIONAL ANESTHESIA

Abstract

Background: Intravenous regional anesthesia is one of the safest and most consistent modes of regional anesthesia for short procedures on upper extremity. Objectives: To evaluate the combination of lidocaine 1 mg/kg with fentanyl 12.5 μg with double cuff distal forearm tourniquet 3 cm above the wrist for short procedures of the hand surgery. Materials and methods: 20 patients scheduled for outpatients short procedures of hand surgery, with one cannula over the dorsum of the operated hand for local anesthetic injection and the other cannula on the other hand for crystalloid infusion during the operation. Lidocaine 1 mg/kg diluted to 10 ml normal saline with fentanyl 12.5 μg diluted to 10 ml normal saline injected over 30 seconds with distal forearm tourniquet placed 3 cm above the wrist. Results: Sensory block started after 3.5 minutes with preserved motor power of the wrist muscles. The operative VAS is 1. Patients haemodynamically stable during the operation with 13 patients very satisfied. Also, surgeon is very satisfied in 15 patients during the procedures. Conclusion: Lidocaine with fentanyl with distal forearm tourniquet is safe method with rapid onset and effective anesthesia.
Keywords: lidocaine, fentanyl, forearm tourniquet