The Analgesic Effect of Three Different Doses of Nitroglycerine When Added to Lidocaine for Intravenous Regional Anesthesia in Trauma Patients; [Travma Hastalarinda Intravenoz Rejyonel Anestezi Icin Lidokaine Eklenmesi Durumunda Uc Farkli Nitrogliserin Dozunun Analjezik Etkisi] Publisher Pubmed



Honarmand A¹ ; Safavi M¹ ; Fatemy A¹ Show Affiliations
Source: Ulusal Travma ve Acil Cerrahi Dergisi Published:2011

Abstract

BACKGROUND Nitroglycerine (NTG) has analgesic properties. The aim of the present study was to assess the analgesic effect of three different doses of NTG (200 μg, 300 μg and 400 μg) when added to lidocaine in intravenous regional anesthesia (IVRA) in trauma patients. METHODS One hundred patients undergoing hand surgery were randomly allocated to four groups to receive 3 mg/kg 2% lidocaine diluted with saline to a total dose of 40 mL in the control group (Group LS, n = 25) or 200, 300, 400 μg NTG plus 3 mg/kg 2% lidocaine diluted with saline to a total dose of 40 mL in the NTG group (Groups LN1, LN2, LN3 respectively; n = 25 in each group). Before and after the tourniquet application, hemodynamic variables, tourniquet pain, sedation, and analgesic use were recorded. RESULTS Sensory and motor block onset times were significantly shorter in the LN3 group compared with Groups LN1, LN2, and LS (p<0.05). Sensory and motor block recovery times were statistically prolonged in the LN3 group when compared with Groups LN1 and LS (p<0.05). Postoperative visual analogue scale (VAS) scores were significantly lower at 2, 4, 8, 12, and 24 hours after tourniquet release in Group LN3 compared with Group LS (p<0.05). CONCLUSION The addition of 400 μg NTG to lidocaine in IVRA shortens the onset of sensory and motor block in trauma patients and improves the quality of anesthesia and perioperative analgesia better than the addition of 200 μg or 300 μg NTG, without causing side effects.