Comparison of Lidocaine-Meperidine with Lidocaine-Meperidine -Nitroglycerin for intravenous regional anesthesia

Intravenous regional anesthesia (IVRA) is a easy and reliable method for extremity injuries. To improve block quality، decrease tourniquet pain and postoperative analgesia different drugs has been used as an adjuvant in IVRA. In this study، we evaluated the effect of nitroglycerin (NTG) in quality improvement when added to lidocaine and Meperidine as an adjuvant in IVRA. Fifthly patient with upper extremity injury under IVRA were randomly and blindly to two groups. Under identical condition، control group received total dose of 200 mg lidocaine and 20 mg Meperidine diluted with saline (40cc) and study group received 200 mg lidocaine and 20 mg Meperidine plus 200g Nitroglycerine. Onset time، anesthesia quality، tourniquet pain and analgesic use were assessed during surgery. After tourniquet deflation، the time to first analgesic requirement and side effect were noted. The sensory block onset time were shortened in study groups (3. 7 1. 1 vs 5. 1 1. 3) (P=0. 004). Intraoperative pain score and quality of analgesic were not different between two groups and fentanyl requirement was similar. The onset of postoperative pain were similar in study and control groups. [78. 79 (61. 28-92. 23) vs 52. 28 (35. 07-73. 448)]. (P=0. 29). Addition of Nitroglycerine to lidocaine and Meperidine in intravenous regional anesthesia shortens onset times of sensory block but is not improved the quality of intraoperative analgesia and postoperative pain in patients undergoing hand surgery.