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Comparative Clinical Study of 0.5% Lignocaine Alone and Combination of 0.25% Lignocaine Withpentazocine and Pancuronium In Intravenous Regional Anaesthesia for Upper Limb Orthopaedic Surgeries

Raghavendra Babu T., 401, Manasa enclave, GSSV Road, Lakshmipuram, Mysuru-570004, Karnataka, India. , Raghavendra Babu T.1 , Malathi C.N.2 , Gurudatt C.L.3

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Indian Journal of Anesthesia and Analgesia 4(3):p 669-672, July - September 2017. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4317.20

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Abstract

Background and Objective: Intravenous regional anaesthesia with conventional large dose of local anaestheticis associated with serious systemic toxicity when the tourniquet deflates unexpectedly during the procedure or when it is deflated intentionally at end of surgery. Therefore modifications in IVRA have been done with the use of low dose of local anaesthetic to decrease systemic toxicity and addition of muscle relaxant and opioid to local anaesthetic to get same quality analgesia as high dose local anaesthetic. Hence the present study is carried out to compare the sensory and motor characteristics, cardiovascular and respiratory parameters and side-effects during intra-operative and postoperative period between the patients who received 0.5% lignocaine alone and those who received combination of 40 ml of 0.25% lignocaine with 30 mg pentazocineand 0.5 mg pancuronium in intravenous regional anaesthesia for upper limb orthopaedic surgeries. Materials and Methods: Sixty unpremedicated ASA class 1 and 2 patients scheduled for elective upper limb orthopaedic surgeries were randomly allocated to receive IVRA either with 40ml of 0.5% lignocaine alone (Group A, n = 30) or combination of 40 ml of 0.25% lignocaine with 30 mg pentazocineand 0.5 mg pancuronium (Group B, n = 30). The sensory and motor characteristics, cardiovascular & respiratory parameters and side effects were studied during the intra-operative and post-operative period. Conclusion: The study indicated that the triple combination of 40 ml of 0.25% lignocaine,30 mg pentazocineand 0.5mg pancuronium produces the same quality of analgesia as 40ml of 0.5% lignocaine in IVRA. But the short delay that was observed in the onset and attainment of complete sensory and motor block in the former group will delay the start of surgery by 10-15 minutes after application of tourniquet. Thus, this modified technique of intravenous regional anaesthesia allows the reduction in the dose of local anaesthetic agent and hence the potential toxicity of the local anaesthetic agent.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4317.20

Keywords

Intravenous Regionalanaesthesia; Tourniquet; Lignocaine; Pentazocine; Pancuronium

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