Document Detail


Bilateral intravenous regional anesthesia: a new method to test additives to local anesthetic solutions.
MedLine Citation:
PMID:  12766653     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Maximilian W B Hartmannsgruber; Sabine Plessmann; Peter G Atanassoff
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Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anesthesiology     Volume:  98     ISSN:  0003-3022     ISO Abbreviation:  Anesthesiology     Publication Date:  2003 Jun 
Date Detail:
Created Date:  2003-05-26     Completed Date:  2003-06-24     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1427-30; discussion 6A     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology, New York University, New York, New York, USA.
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MeSH Terms
Descriptor/Qualifier:
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:
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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