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Continuous intravenous regional anesthesia.

L T Glickman1, S E Mackinnon, T V Rao

  • 1Department of Surgery, University of Toronto, Ont., Canada.

The Journal of Hand Surgery
|January 1, 1992
PubMed
Summary
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Continuous intravenous regional anesthesia provides safe and effective prolonged anesthesia for upper extremity surgery. This technique offers advantages similar to brachial plexus block or general anesthesia.

Area of Science:

  • Anesthesiology
  • Orthopedic Surgery
  • Regional Anesthesia

Background:

  • Prolonged upper extremity surgeries require effective and safe anesthetic techniques.
  • Traditional methods like brachial plexus block or general anesthesia have limitations.
  • Intravenous regional anesthesia (IVRA) offers safety and ease but may have duration limits.

Purpose of the Study:

  • To evaluate the effectiveness and safety of continuous intravenous regional anesthesia (cIVRA) for extended upper extremity procedures.
  • To identify factors influencing outcomes, including patient demographics, tourniquet times, anesthetic doses, and complications.

Main Methods:

  • Retrospective analysis of 72 procedures on 34 patients undergoing upper extremity surgery.
  • Data collected included patient characteristics, tourniquet application/release times, anesthetic and adjunctive drug dosages, technical complications, and side effects.

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  • Continuous intravenous regional anesthesia was administered for prolonged surgical durations.

    • Main Results:

    • Mean total tourniquet time was 91 minutes, with mean total anesthetic dose of 402 mg.
    • Low incidence of complications: two (6%) technical complications and two (6%) patients experienced side effects.
    • cIVRA demonstrated feasibility for lengthy procedures.

    Conclusions:

    • Continuous intravenous regional anesthesia is a safe and reliable anesthetic option for prolonged upper extremity surgery.
    • It provides extended anesthesia duration comparable to brachial plexus block or general anesthesia.
    • cIVRA should be considered a viable alternative anesthetic method for upper extremity surgical interventions.