Hostname: page-component-848d4c4894-jbqgn Total loading time: 0 Render date: 2024-06-24T23:05:38.587Z Has data issue: false hasContentIssue false

Addition of dexmedetomidine to lidocaine for intravenous regional anaesthesia

Published online by Cambridge University Press:  02 June 2005

A. Esmaoglu
Affiliation:
Erciyes University Medical Faculty, Department of Anaesthesiology and Reanimation, Kayseri, Turkey
A. Mizrak
Affiliation:
Erciyes University Medical Faculty, Department of Anaesthesiology and Reanimation, Kayseri, Turkey
A. Akin
Affiliation:
Erciyes University Medical Faculty, Department of Anaesthesiology and Reanimation, Kayseri, Turkey
Y. Turk
Affiliation:
Erciyes University Medical Faculty, Department of Orthopedic Surgery and Traumatology, Kayseri, Turkey
A. Boyaci
Affiliation:
Erciyes University Medical Faculty, Department of Anaesthesiology and Reanimation, Kayseri, Turkey
Get access

Extract

Summary

Background and objective: The aim of this study was to determine the duration of onset and regression time of sensory and motor blocks, the quality of anaesthesia and postoperative analgesia by the addition of dexmedetomidine to local anaesthetic solution in intravenous regional anaesthesia (IVRA).

Methods: Forty patients scheduled for elective hand surgery participated in this prospective randomized double-blind study. The IVRA was achieved using 3 mg kg−1 lidocaine diluted with saline to a total volume of 40 mL in the control group or 1 μg kg−1 of dexmedetomidine +3 mg kg−1 lidocaine diluted with saline to a total volume of 40 mL in the dexmedetomidine group. The onset and regression times for sensory and motor blocks were recorded. Qualities of anaesthesia, intraoperative and postoperative analgesic requirements were noted.

Results: There was no difference between the groups with respect to sensory and motor blocks onset and regression time. The quality of anaesthesia was better in the dexmedetomidine group than the control group and the difference was statistically significant. Intraoperative and postoperative analgesic requirements were greater in the control group than in the dexmedetomidine group.

Conclusions: Addition of dexmedetomidine to local anaesthetic solution in IVRA improved the quality of anaesthesia and decreased analgesic requirements, but had no effect on the sensory and motor blocks onset and regression times.

Type
Original Article
Copyright
© 2005 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented at Euroanaesthesia Lisbon, 5–8 June 2004.

References

Gupta A, Bjornsson A, Sjoberg F, Bengtsson M. Lack of peripheral analgesic effect of low-dose morphine during intravenous regional anesthesia. Reg Anesth 1993; 18: 250253.Google Scholar
Armstrong P, Power I, Wildsmith JA. Addition of fentanyl to prilocaine for intravenous regional anaesthesia. Anaesthesia 1991; 46: 278280.Google Scholar
Corpataux JB, Van Gessel EF, Donald FA, Forster A, Gamulin Z. Effect on postoperative analgesia of small-dose lysine acetylsalicylate added to prilocaine during intravenous regional anesthesia. Anesth Analg 1997; 84: 10811085.Google Scholar
Armstrong P, Watters J, Whitfield A. Alkalinisation of prilocaine for intravenous regional anaesthesia. Suitability for clinical use. Anaesthesia 1990; 45: 935937.Google Scholar
Reuben SS, Steinberg RB, Kreitzer JM, Duprat KM. Intravenous regional anesthesia using lidocaine and ketorolac. Anesth Analg 1995; 81: 110113.Google Scholar
Reuben SS, Steinberg RB, Klatt JL, Klatt ML. Intravenous regional anesthesia using lidocaine and clonidine. Anesthesiology 1999; 91: 654658.Google Scholar
Gentili M, Bernard JM, Bonnet F. Adding clonidine to lidocaine for intravenous regional anesthesia prevents tourniquet pain. Anesth Analg 1999; 88: 13271330.Google Scholar
Bhana N, Goa KL, McClellan KJ. Dexmedetomidine. Drugs 2000; 59: 263268.Google Scholar
Gaumann DM, Brunet PC, Jirounek P. Clonidine enhances the effects of lidocaine on C-fiber action potential. Anesth Analg 1992; 74: 719725.Google Scholar
Lurie SD, Reuben SS, Gibson CS, DeLuca PA, Maciolek HA. Effect of clonidine on upper extremity tourniquet pain in healthy volunteers. Reg Anesth Pain Med 2000; 25: 502505.Google Scholar
Rabin BC, Reid K, Guo TZ, Gustafsson E, Zhang C, Maze M. Sympatholytic and minimum anesthetic concentration-sparing responses are preserved in rats rendered tolerant to the hypnotic and analgesic action of dexmedetomidine, a selective alpha(2)-adrenergic agonist. Anesthesiology 1996; 85: 565573.Google Scholar
Salmenpera MT, Szlam F, Hug Jr CC. Anesthetic and hemodynamic interactions of dexmedetomidine and fentanyl in dogs. Anesthesiology 1994; 80: 837846.Google Scholar
Aho M, Lehtinen AM, Erkola O, Kallio A, Korttila K. The effect of intravenously administered dexmedetomidine on perioperative hemodynamics and isoflurane requirements in patients undergoing abdominal hysterectomy. Anesthesiology 1991; 74: 9971002.Google Scholar
Fragen RJ, Fitzgerald PC. Effect of dexmedetomidine on the minimum alveolar concentration (MAC) of sevoflurane in adults age 55 to 70 years. J Clin Anesth 1999; 11: 466470.Google Scholar
Aho M, Erkola O, Kallio A, Scheinin H, Korttila K. Dexmedetomidine infusion for maintenance of anesthesia in patients undergoing abdominal hysterectomy. Anesth Analg 1992; 75: 940946.Google Scholar
Aho MS, Erkola OA, Scheinin H, Lehtinen AM, Korttila KT. Effect of intravenously administered dexmedetomidine on pain after laparoscopic tubal ligation. Anesth Analg 1991; 73: 112118.Google Scholar
Salonen M, Reid K, Maze M. Synergistic interaction between alpha 2-adrenergic agonists and benzodiazepines in rats. Anesthesiology 1992; 76: 10041011.Google Scholar
Sato J, Perl ER. Adrenergic excitation of cutaneous pain receptors induced by peripheral nerve injury. Science 1991; 251: 16081610.Google Scholar
Kamibayashi T, Maze M. Clinical uses of alpha2-adrenergic agonists. Anesthesiology 2000; 93: 13451349.Google Scholar
Memis D, Turan A, Karamanlioglu B, Pamukcu Z, Kurt I. Adding dexmedetomidine to lidocaine for intravenous regional anesthesia. Anesth Analg 2004; 98: 835840.Google Scholar
Kallio A, Scheinin M, Koulu M, et al. Effects of dexmedetomidine, a selective alpha 2-adrenoceptor agonist, on hemodynamic control mechanisms. Clin Pharmacol Ther 1989; 46: 3342.Google Scholar