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Updated: Jan 20, 2026
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
[Intravenous regional anesthesia]
Mohammad Tezval1, Christopher Spering2
1Klinik für Unfallchirurgie, Sporttraumatologie und Handchirurgie, Dorstener Str. 151, 45657, Recklinghausen, Deutschland. mohammad.tezval@klinikum-vest.de.
Objective:
Intravenous regional anesthesia.
Indications:
Short duration hand operations.
Contraindications:
Open wounds, lengthy operations, local infections, polyneuropathy, Raynaud syndrome, allergy to local anesthetics.
Technique:
Insertion of an intravenous cannula, attachment of a double lumen cuff, Esmarch's tourniquet, injection of the local anesthetic, stepwise pumping up the tourniquet, surgery, stepwise removal of the tourniquet.
Postoperative Management:
Postoperative monitoring of the patient after the end of anesthesia.
Results:
Over a time period of 2 years (January 2017-December 2018) 90 operations of the hand were carried out with the patient under intravenous regional anesthesia (IVRA). The average age of the patients was 61 years. After surgery the patients were questioned according to the criteria of the quality of recovery‑9 score according to Myles in the German version of Eberhard et al. (2002). The tourniquet could be removed on average 29 min after surgery. No intraoperative or postoperative complications occurred. Therefore, the IVRA represents a reliable and simple form of anesthesia especially for surgery of the hand.
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