Supraclavicular block vs. intravenous regional anaesthesia for forearm surgery

The purpose of this study was to compare the analgesic effect between intravenous regional anesthesia (IVRA) and supraclavicular block in forearm surgery.

Eighty patients aged 30 to 70 years for forearm surgery were divided into Supraclavicular group and IVRA group. Supraclavicular block was performed with 1% lidocaine 20 mL. After analgesia was obtained, single tourniquet was used at 200 mmHg. For patients in the IVRA group, an intravenous catheter was inserted in the dorsum of the hand of surgery, double tourniquet was placed, an elastic bandage was wound up, then 1% lidocaine 20 mL was injected after proximal tourniquet was inflated at 200 mmHg. When analgesia did not occur in 30 minutes, the block was judged as a failure, and general anesthesia was administered. The onset time of analgesia, time to the first tourniquet pain, and duration of postoperative analgesia were measured. When patients felt pain at surgical site during surgery, fentanyl 50 μg was administered. Side effects were also checked.

Onset time, duration of postoperative analgesia, and time to the tourniquet pain were significantly shorter in the IRVA group. Number of patients with tourniquet pain was significantly larger and number of patients with additional fentanyl was significantly smaller in the IRVA group. No patients showed any side effects.

IVRA had shorter onset time and needed less additional anesthetics during surgery, but induced more tourniquet pain and shorter duration of postoperative analgesia than supraclavicular block when 1% lidocaine 20 mL was used for forearm surgery.