TY - JOUR
AR - ACR-2024-1-101
TI - Comparison of Low Doses of Lidocaine in Terms of Efficacy, Reliability, and Satisfaction in Ambulatory Hand Surgery Using Intravenous Regional Anaesthesia with Forearm Tourniquet: A Prospective, Randomized Controlled Trial
AU - Meral Erdal, ERBATUR
AU - Ali, OZDEMIR
AU - Canan, Tiryaki
AU - Serkan, Erbatur
AU - Sedat, Kaya
AU - Osman, Uzundere
JO - Anesthesia and Clinical Research
PY - 2024
DA - Fri 23, Feb 2024
SN - 2733-2500
DO - http://dx.doi.org/10.31487/j.ACR.2024.01.01
UR - https://www.sciencerepository.org/comparison-of-low-doses-of-lidocaine_ACR-2024-1-101 
KW - Intravenous regional anaesthesia, forearm tourniquets, hand surgery, low dose local anaesthetic
AB - Objective: This study aimed to assess efficacy, complications, and surgeon and patient satisfaction related to forearm intravenous regional anaesthesia using low doses of lidocaine in ambulatory hand surgery.
Methods: This prospective, randomized and double-blind study included patients who received 25 ml (125 mg; Group 1; n = 35) and 15 ml (75 mg; Group 2; n = 35) of 0.5% lidocaine. Data recorded included sociodemographic variables, intraoperative hemodynamic findings, time to onset of sensory and motor block, intensity of motor block, duration of tourniquet tolerance, need for additional local anaesthetic and sedation, development of intraoperative complications, perioperative visual analog scale values, and patient and surgeon satisfaction.
Results: Group 2 showed significantly longer time to onset of motor and sensory block than Group 1 (p = 0.033 and 0.015, respectively). Group 2 showed a significantly weaker intensity of motor block than Group 1 (p < 0.001). Only one patient in Group 2 required additional local anaesthetic. No patient developed major complications.
Conclusion: Forearm intravenous regional anaesthesia using a low dose of 0.5% lidocaine (75 mg; 15 ml) can provide adequate and safe surgical anaesthesia in ambulatory surgery of the hand. Furthermore, weaker motor blockade may assist the surgical team, especially in tendon surgeries. Therefore, the use of a lidocaine dose almost equivalent to the quantity used in IV induction of anaesthesia can achieve safe and effective anaesthesia in hand surgery.
Level of Evidence: Level I, therapeutic study.