Abstract

A COMPARATIVE STUDY OF LIDOCAINE–DEXMEDETOMIDINE AND LIDOCAINE–SALINE FOR INTRAVENOUS REGIONAL ANAESTHESIA DURING UPPER LIMB SURGERIES

Dr. Ketki Jandial* and Dr. Mamta Gupta

ABSTRACT

Background: Intravenous regional anesthesia (IVRA) is simple and reliable. Very few reports have evaluated effects of dexmedetomidine as an additive to local anesthetics in IVRA and even fewer demonstrating the effect of dexmedetomidine when added to lidocaine. Therefore, this study compared the effects of adding dexmedetomidine or saline to lidocaine in distal forearm and hand surgery, and to evaluate quality of block, tourniquet pain and post-operative analgesia. Method: A randomized double‑blind clinical trial was performed on 60 patients, age 18 years or above, scheduled for various minor and major procedures involving upper extremities, in the Department of Anesthesia, Government Medical College, Jammu, conducted over a period of 6 months. Patients were allocated randomly into two groups, both receiving 20 ml, 0.5% lignocaine: Group A with dexmedetomidine 1 μg/kg in 1.0 ml and Group B with 0.9% saline as additive. Results: In Group A, complete sensory block onset time, complete motor block onset time and duration of sensory block were achieved at 8.9 ± 2.2 min, 12.5 ± 2.3 min and 45.6 ± 7.8 min respectively, which were significantly lower to those of Group B. Duration of analgesia was 217.48 ± 19.65 min for Group A and 128.81 ± 11.29 for Group B. There was a decrease in tourniquet inflation and a significantly lower VAS in the lignocaine- dexmedetomidine group. Post-operative VAS scores also favored Group A. Conclusion: Addition of 1 μg/kg dexmedetomidine to lignocaine for IVRA showed significantly better results in comparison to lignocaine-only, without causing any significant side-effects.

Keywords: Intravenous Regional Anesthesia (IVRA), Dexmedetomidine, Lidocaine, Distal Forearm and Hand Surgery, Tourniquet, Post Operative Analgesia.