ORIGINAL ARTICLE
Supraclavicular block vs. intravenous regional anaesthesia
for forearm surgery
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Department of Anaesthesiology, Kamakura Hospital, Kamakura, Kanagawa, Japan
Publication date: 2019-09-12
Anaesthesiol Intensive Ther 2019;51(1):17-20
KEYWORDS
ABSTRACT
Background:
The purpose of this study was to compare the analgesic effect during and after surgery between intravenous
regional anaesthesia (IVRA) and the supraclavicular block in forearm surgery.
Methods:
Eighty patients aged 30 to 70 years qualified for forearm surgery were divided into a supraclavicular group
and an IVRA group. A supraclavicular block was performed with 1% lidocaine at a dose of 20 mL. After anaesthesia
was obtained, a single tourniquet was used at a pressure of 200 mm Hg. For the patients in the IVRA group, an intravenous
catheter was first inserted in the dorsum of the hand marked for surgery, followed by the placement of a double
tourniquet with an elastic bandage wound around it. Once the proximal tourniquet was inflated to a pressure of 200
mm Hg, 1% lidocaine at a dose of 20 mL was injected. When anaesthesia had not been obtained within 30 minutes,
the block was judged to have been failure, and general anaesthesia was administered. The onset time of analgesia, to
time up to the first sensation of tourniquet pain, and the duration of postoperative analgesia were measured. When
patients felt pain at a surgical site during surgery, 50 μg of fentanyl was administered. Any side effects were also checked
Results:
The onset time, the duration of postoperative analgesia, and the time up to the sensation of tourniquet
pain were significantly shorter in the IRVA group. Other features of the IRVA group were that the number of patients
with tourniquet pain was significantly larger and the number of patients with additional fentanyl was significantly
smaller. No patients showed any side effects
Conclusion:
Although IVRA had a shorter onset time and needed less additional anaesthetic during surgery, it induced
more tourniquet pain and had a shorter duration of postoperative analgesia than the supraclavicular block
in forearm surgery.