The Combination Effect of Lidocaine, Ketamine and Atracurium in Intravenous Regional Anesthesia
Background: intravenous regional anaesthesia (IVRA) is an effective method of producing anaesthesia of the extremities. Disadvantages are the rapid loss of anaesthesia after the deflation of the tourniquet and the rapid development of postoperative pain. It is important to search for agents with lo...
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| Format: | Article |
| Language: | English |
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University of Baghdad/ Al-Kindy College of Medicine
2013-06-01
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| Series: | مجله كليه طب الكندي |
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| Online Access: | https://jkmc.uobaghdad.edu.iq/index.php/MEDICAL/article/view/531 |
| _version_ | 1798036525543325696 |
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| author | Hassan Sarhan Haider Faez Ahmed Mahdi |
| author_facet | Hassan Sarhan Haider Faez Ahmed Mahdi |
| author_sort | Hassan Sarhan Haider |
| collection | DOAJ |
| description |
Background: intravenous regional anaesthesia (IVRA) is an effective method of producing anaesthesia of the extremities. Disadvantages are the rapid loss of anaesthesia after the deflation of the tourniquet and the rapid development of postoperative pain. It is important to search for agents with longer durations of action, better nerve fibre selectivity, lesser degrees of motor blockade and lower incidences of systemic toxicity.Objectives: This study was designed to evaluate and compare the clinical effects of intravenous regional anaesthesia, with lidocaine alone, or in a combination with ketamine and atracurium for better analgesia, and to examine the possible clinical advantages of using muscle relaxants (i.e., atracurium) with intravenous regional anaesthesia.Methods: In prospective, randomized study, sixty patient ASA physical status I, aged 20-50years underwent surgeries on distal regions of upper limbs, patient assigned randomly into 3 groups each of 20 patients, group I received 30ml of 0.5% lidocaine (150mg), group II received 30ml of mixing 0.5% of lidocaine (100mg) plus 30mg ketamine, while group III received 30ml of mixing 0.5% lidocaine (100mg) plus 30mg ketamine plus 2mg atracurium. All the results were tabulated and analyzed statistically with student's unpaired t-test and chi-square test. Results: Addition of 30mg of ketamine to 0.5% lidocaine resulted in rapid onset of sensory block, motor block, and lower visual analogue scale scores for pain compared with the group that received lidocaine only. The addition of atracurium to the combination of lidocaine and ketamine resulted in improved operating conditions and rapid onset of both sensory and motor blocks with less pain during surgery.Conclusions: drug combination of ketamine, atracurium and low dose of lidocaine lead to rapid onset of sensory block, motor block, lower VAS score for pain, and decrease adverse effect of Bier’s block accompany lidocaine alone, decrease drowsiness which accompany ketamine use alone in IVRA
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| first_indexed | 2024-04-11T21:14:05Z |
| format | Article |
| id | doaj.art-b72d14b5a8a04342b58850fb7e64b93e |
| institution | Directory Open Access Journal |
| issn | 1810-9543 2521-4365 |
| language | English |
| last_indexed | 2024-04-11T21:14:05Z |
| publishDate | 2013-06-01 |
| publisher | University of Baghdad/ Al-Kindy College of Medicine |
| record_format | Article |
| series | مجله كليه طب الكندي |
| spelling | doaj.art-b72d14b5a8a04342b58850fb7e64b93e2022-12-22T04:02:53ZengUniversity of Baghdad/ Al-Kindy College of Medicineمجله كليه طب الكندي1810-95432521-43652013-06-0192The Combination Effect of Lidocaine, Ketamine and Atracurium in Intravenous Regional AnesthesiaHassan Sarhan Haider0Faez Ahmed Mahdi1Department of anesthesia and ICU. Baghdad Teaching Hospital, Medical City Complex.Department of anesthesia and ICU. Baghdad Teaching Hospital, Medical City Complex. Background: intravenous regional anaesthesia (IVRA) is an effective method of producing anaesthesia of the extremities. Disadvantages are the rapid loss of anaesthesia after the deflation of the tourniquet and the rapid development of postoperative pain. It is important to search for agents with longer durations of action, better nerve fibre selectivity, lesser degrees of motor blockade and lower incidences of systemic toxicity.Objectives: This study was designed to evaluate and compare the clinical effects of intravenous regional anaesthesia, with lidocaine alone, or in a combination with ketamine and atracurium for better analgesia, and to examine the possible clinical advantages of using muscle relaxants (i.e., atracurium) with intravenous regional anaesthesia.Methods: In prospective, randomized study, sixty patient ASA physical status I, aged 20-50years underwent surgeries on distal regions of upper limbs, patient assigned randomly into 3 groups each of 20 patients, group I received 30ml of 0.5% lidocaine (150mg), group II received 30ml of mixing 0.5% of lidocaine (100mg) plus 30mg ketamine, while group III received 30ml of mixing 0.5% lidocaine (100mg) plus 30mg ketamine plus 2mg atracurium. All the results were tabulated and analyzed statistically with student's unpaired t-test and chi-square test. Results: Addition of 30mg of ketamine to 0.5% lidocaine resulted in rapid onset of sensory block, motor block, and lower visual analogue scale scores for pain compared with the group that received lidocaine only. The addition of atracurium to the combination of lidocaine and ketamine resulted in improved operating conditions and rapid onset of both sensory and motor blocks with less pain during surgery.Conclusions: drug combination of ketamine, atracurium and low dose of lidocaine lead to rapid onset of sensory block, motor block, lower VAS score for pain, and decrease adverse effect of Bier’s block accompany lidocaine alone, decrease drowsiness which accompany ketamine use alone in IVRA https://jkmc.uobaghdad.edu.iq/index.php/MEDICAL/article/view/531LidocainKetaminAtracuruimBier’s block |
| spellingShingle | Hassan Sarhan Haider Faez Ahmed Mahdi The Combination Effect of Lidocaine, Ketamine and Atracurium in Intravenous Regional Anesthesia مجله كليه طب الكندي Lidocain Ketamin Atracuruim Bier’s block |
| title | The Combination Effect of Lidocaine, Ketamine and Atracurium in Intravenous Regional Anesthesia |
| title_full | The Combination Effect of Lidocaine, Ketamine and Atracurium in Intravenous Regional Anesthesia |
| title_fullStr | The Combination Effect of Lidocaine, Ketamine and Atracurium in Intravenous Regional Anesthesia |
| title_full_unstemmed | The Combination Effect of Lidocaine, Ketamine and Atracurium in Intravenous Regional Anesthesia |
| title_short | The Combination Effect of Lidocaine, Ketamine and Atracurium in Intravenous Regional Anesthesia |
| title_sort | combination effect of lidocaine ketamine and atracurium in intravenous regional anesthesia |
| topic | Lidocain Ketamin Atracuruim Bier’s block |
| url | https://jkmc.uobaghdad.edu.iq/index.php/MEDICAL/article/view/531 |
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