Early Versus Late Distal Tourniquet Deflation of Intravenous Regional Anesthesia for Hand and Forearm Surgery | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 80, Volume 98, Issue 1, January 2025, Page 551-555 PDF (597.96 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejhm.2025.407389 | ||||
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| Abstract | ||||
| Background: The time of distal tourniquet inflation in intravenous regional anesthesia (IVRA) or Bier's block is still arbitrary and no safe period interval from the local anesthetic injection to distal tourniquet deflation has been established to avoid local anesthetic toxicity. Objective: This study aimed to compare the risk of local anaesthetic toxicity in early versus late distal tourniquet deflation of IVRA for hand and forearm surgeries. Patients and methods: This study was carried out on 40 patients, scheduled for hand or forearm surgery.They were divided into two equal groups: Early deflation group (ED) and late deflation group (LD). In the ED group the distal tourniquet deflated after 20 minutes of induction of IVRA and in the LD group the deflation performed at the end of surgery but not more than 60 minutes after induction of IVRA. Any systemic local anesthetic toxicity was recorded and compared between both groups during the procedure and every 2 hours postoperatively for 24 hours. Hemodynamic effects and sensory and motor block recovery times in both studied groups were reported and compared. Surgeon and patient satisfactions were recorded and statistically compared in both groups. Results:No local anesthetic systemic toxicity (LAST) effects were recorded in both groups of early and late deflation of distal tourniquet in IVRA for hand and forearm surgery. Also, with comparable hemodynamic effects and sensory and motor block recovery times in both studied groups as p-values were < 0.05. Surgeon and patient satisfactions were more in early deflation group than in late deflation group but statistically insignificant (p-value <0.05). Conclusions: In this study;there is no difference as regard symptoms and signs of LAST between early and late deflation groups of distal tourniquet in IVRA for hand and forearm surgeries. Also with no significant differences in; hemodynamic effects, sensory and motor block recovery time and surgeon and patient satisfactions. | ||||
| Keywords | ||||
| IVRA; Tourniquet deflation; Hand and forearm surgery | ||||
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