The Analgesic Effect of Intravenous Neostigmine and Transdermal Nitroglycerine Added to Lidocaine on Intravenous Regional Anesthesia (Bier`s Block): A Randomized, Controlled Study in Hand Surgery
Titel:
The Analgesic Effect of Intravenous Neostigmine and Transdermal Nitroglycerine Added to Lidocaine on Intravenous Regional Anesthesia (Bier`s Block): A Randomized, Controlled Study in Hand Surgery
This study was conducted to determine whether intravenous neostigmine, Transdermal Nitroglycerine (NTG) and combination of them enhance analgesia from lidocaine in Bier`s block. Eighty patients with American Society of Anesthesiologist (ASA) physical statuses 1, 2 scheduled for elective hand surgery were included in the study. Participants were computer randomized to four groups with 20 patients in each group. All patients received Intravenous Regional Anesthesia (IVRA) with 3 mg kg-1 0.5% lidocaine. Neostigmine group (group 1) received IVRA with 0.5 mg neostigmine added to lidocaine. Nitroglycerine (NTG) group (group 2) received transdermal patch comprise of 5 mg NTG (was applied at the proximal forearm) added to lidocaine. NTG-neostigmine group (group 3) received simultaneously neostigmine and transdermal NTG patch in addition to lidocaine. The control group (group 4) received IVRA with 2 mL saline added to lidocaine. A repeated measure analysis of variance (ANOVA) model was used for statistical analysis. Tourniquet pain onset was not significantly different between groups (p = 0.158). However there was significant differences in surgical pain onset (p<0.001). ANOVA analysis revealed that surgical pain onset was significantly longer in neostigmine group and neostigmine- NTG group in contrast with control group (p = 0.001, p<0.001, respectively). Severity of pain between groups was not significant before injection, at the time of injection, as well as at 30, 60, 90 and 120 min after injection (p = 0.123). Prolonged surgical pain onset in group 1 (neostigmine) and group 3 (NTG and neostigmine) revealed that only neostigmine besides lidocaine in Bier`s block have an influencing role to lengthen surgical pain onset however it could not be able to decrease severity of surgical pain in the bier`s block.
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Asian Network for Scientific Information, Pakistan (provided by DOAJ)