56794

ADDITION OF PANCURONIUM AND NITROGLYCERIN TO LIDOCAINE FOR INTRAVENOUS REGIONAL ANESTHESIA IN UPPER EXTREMITY SURGERY: BLOCK CHARACTERISTICS AND POSTOPERATIVE ANALGESIA

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Last updated: 04 Jan 2025

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Abstract

Background: Intravenous regional anesthesia (IVRA) provides reliable and rapid analgesia with good muscle relaxation of the extremity distal to the tourniquet, but tourniquet pain and absence of post-operative analgesia are major drawbacks. Nitroglycerine and muscle relaxants are known to potentiate peripheral nerve blocks. Objective: Comparing nitroglycerine and pancuronium as adjuvants to IVRA with respect, block characteristics, and post- operative analgesia. Patient and Methods: This study was carried out in Al- Azhar University Hospitals for 6 months ( from 1/4/2016 to 1/10/2016 ) on 60 patients of both sexes aged 20-50 years, and belonging to ASA I & II  undergoing forearm and hand surgeries. Patients were randomely divided into three equal groups ( 20 patients at each group ) . Group I received 40 cc of 3 mg/kg of lidocaine diluted in normal saline (0.9 % NaCl), Group II recieved 40 cc of 1.5 mg/kg of lidocaine diluted in normal saline (0.9% NaCl) with 200 µg nitroglycerine, and Group III received 40 cc of 1.5 mg/kg of lidocaine diluted in normal saline (0.9 % NaCl with 200 µg nitroglycerin and 0.5 mg pancuronium. Results: Group I has the slowest sensory and motor onset time, but the shortest sensory and motor recovery time. There was no significant difference between Group II and III as regarding sensory onset and recovery times, but Group III  has shoter motor onset time and more prolonged motor recovery  time  than Group II. As regard postoperative analgesic requirements, Group II and III needed less analgesic doses than Group I, but there was no significant difference between Group II and III. Conclusion: Addition of 0.5 mg  pancuronium and 200 µg nitroglycerin as adjuvant to lidocaine for intravenous regional anesthesia reduced the dose of lidocaine used for IVRA, shortened the sensory and motor block onset times, prolonged the sensory and motor block recovery times, and reduced the postoperative analgesic requirement and improved the quality of intravenous regional anesthesia with no side effects.

DOI

10.12816/0040347

Keywords

Lidocaine, nitroglycerine, pancuronium, Intravenous regional anesthesia

Authors

First Name

Mostafa

Last Name

M. Mahdy

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Affiliation

Anesthesia and Intensive Care Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

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First Name

Abdulla

Last Name

M. Ahmed

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Affiliation

Anesthesia and Intensive Care Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

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Orcid

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First Name

Mostafa

Last Name

M. Sabra

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Affiliation

Anesthesia and Intensive Care Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

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Orcid

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First Name

Ahmed

Last Name

S. Hamada

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Affiliation

Anesthesia and Intensive Care Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

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Volume

46

Article Issue

3

Related Issue

8502

Issue Date

2017-07-01

Receive Date

2017-07-01

Publish Date

2017-07-01

Page Start

581

Page End

594

Print ISSN

1110-0400

Link

https://amj.journals.ekb.eg/article_56794.html

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https://amj.journals.ekb.eg/service?article_code=56794

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3

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Original Article

Type Code

941

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Journal

Publication Title

Al-Azhar Medical Journal

Publication Link

https://amj.journals.ekb.eg/

MainTitle

ADDITION OF PANCURONIUM AND NITROGLYCERIN TO LIDOCAINE FOR INTRAVENOUS REGIONAL ANESTHESIA IN UPPER EXTREMITY SURGERY: BLOCK CHARACTERISTICS AND POSTOPERATIVE ANALGESIA

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Article

Created At

22 Jan 2023