| Bilateral intravenous regional anesthesia: a new method to test additives to local anesthetic solutions. | |
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MedLine Citation:
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PMID: 12766653 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Ketorolac, when added to lidocaine, has been shown to reduce early tourniquet pain during intravenous regional anesthesia (i.v.RA) in patients. Although the effectiveness of ropivacaine 0.2% for i.v.RA is equal to that of lidocaine 0.5% but significantly reduces central nervous system side effects after release of the tourniquet, it provides no advantage with regard to tourniquet tolerance times. Simultaneous bilateral i.v.RA with ropivacaine 0.2% was used to test the hypothesis that ketorolac modifies tourniquet tolerance and to test whether drug combinations can be evaluated in one study session. METHODS: Ten healthy, unsedated volunteers received 30 ml of ropivacaine 0.2% in each upper arm with 2 ml of normal saline in one arm and 30 mg of ketorolac in the contralateral arm for i.v.RA. Both proximal tourniquets remained inflated for 30 min, followed by inflation of the distal tourniquets and release of the proximal ones. Verbal numeric scores for tourniquet pain were recorded for both extremities. Central nervous system side effects were graded after release of each distal tourniquet. RESULTS: There was no difference between the two upper extremities with regard to surgical anesthesia and tourniquet tolerance. Total tourniquet tolerance was a median of 58.5 min (range, 45-90 min) and 60.5 min (39-79 min) in the normal saline and ketorolac groups, respectively. After release of the distal tourniquets, 5 of 10 volunteers experienced mild dizziness. CONCLUSIONS: The addition of ketorolac to ropivacaine does not improve tourniquet tolerance. Minimal central nervous system side effects after tourniquet release suggest that a total of 60 ml ropivacaine 0.2% for bilateral i.v.RA is a useful model for comparison of i.v.RA drug combinations. |
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Authors:
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Maximilian W B Hartmannsgruber; Sabine Plessmann; Peter G Atanassoff |
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Publication Detail:
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Type: Clinical Trial; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Anesthesiology Volume: 98 ISSN: 0003-3022 ISO Abbreviation: Anesthesiology Publication Date: 2003 Jun |
Date Detail:
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Created Date: 2003-05-26 Completed Date: 2003-06-24 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 1300217 Medline TA: Anesthesiology Country: United States |
Other Details:
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Languages: eng Pagination: 1427-30; discussion 6A Citation Subset: AIM; IM |
Affiliation:
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Department of Anesthesiology, New York University, New York, New York, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Amides / administration & dosage, adverse effects, pharmacology Anesthesia, Conduction* Anesthesia, Intravenous* Anesthetics, Local / administration & dosage, adverse effects, pharmacology* Anti-Inflammatory Agents, Non-Steroidal / administration & dosage, adverse effects, pharmacology Arm / physiology Double-Blind Method Drug Combinations Female Functional Laterality Humans Ketorolac / administration & dosage, adverse effects, pharmacology Male Middle Aged Pain Measurement |
| Chemical | |
Reg. No./Substance:
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0/Amides; 0/Anesthetics, Local; 0/Anti-Inflammatory Agents, Non-Steroidal; 0/Drug Combinations; 66635-83-4/Ketorolac; 84057-95-4/ropivacaine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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