Comparison of Lidocaine-Nitroglycerine with Lidocaine for Intravenous Regional Anesthesia

Intravenous regional anesthesia (IVRA) is a simple and reliable method for upper extremity injuries. Different additives have been combined with local anesthetics to improve block quality, decrease tourniquet pain and postoperative analgesia in IVRA. This study was performed to evaluate the effect of nitroglycerine on tourniquet pain and intraoperative analgesia when added to lidocaine for IV regional anesthesia. In a clinical trial, 50 patients with upper extremity injury were scheduled for IVRA, randomly allocated into two groups. They were unified by age and gender. Under identical condition, control group received a total dose of 200 mg lidocaine diluted with saline (40 cc) and study group received 200 mg lidocaine plus 200 µg nitroglycerine diluted with saline (40 cc). Anesthesia quality, tourniquet pain and opioid requirement were measured during surgery. After the tourniquet deflation, time to first analgesic requirement was noted. Intraoperative pain scores were not different between two groups and fentanyl requirement was similar. The onset of tourniquet pain was similar in case (21.96±3.87 min) and control group (21.12±3.33 min) (p=0.41). Analgesia time and time of initial analgesic requirement after tourniquet deflation was 54.4±9.95 min in control group and 60.40±10.17 min in case group (p=0.625). Addition of nitroglycerine to lidocaine was not improved the quality of IVRA, postoperative analgesia and opioid requirements in patients undergoing hand surgery.