Bier Block, Hand Surgery
Conditions
Keywords
Systemic Fentanyl Infusion, Fentanyl Added as An Adjuvant to Lidocaine
Brief summary
Injury and deformity of the upper extremity can result in dysfunction to nerves, tendons and bones which can lead to disability and pain. Various techniques of regional anesthesia are frequently used for upper extremity surgery. Specifically, intravenous regional anesthesia, the Bier block, is an effective anesthetic technique. This technique, developed by Dr August Bier in 1908, provides complete anesthesia, a bloodless field, and eliminates the need for general anesthesia. However, it was not until the 1960s that this technique was reintroduced and used in upper extremity surgery due to several disadvantages and reports of major complications. Because of the dose of lidocaine and tourniquet time, there is potential for cardiac and neurological complications such as arrhythmias, seizures, and compartment syndrome the aim of this study To evaluate the effect of Systemic Fentanyl Infusion compared to addition of Fentanyl as An Adjuvant to Lidocaine in Bier Block for Controlling Pain in Patients Undergoing Hand Surgeries
Detailed description
Injury and deformity of the upper extremity can result in dysfunction to nerves, tendons and bones which can lead to disability and pain. Various techniques of regional anesthesia are frequently used for upper extremity surgery. Specifically, intravenous regional anesthesia, the Bier block, is an effective anesthetic technique. This technique, developed by Dr August Bier in 1908, provides complete anesthesia, a bloodless field, and eliminates the need for general anesthesia. However, it was not until the 1960s that this technique was reintroduced and used in upper extremity surgery due to several disadvantages and reports of major complications. Because of the dose of lidocaine and tourniquet time, there is potential for cardiac and neurological complications such as arrhythmias, seizures, and compartment syndrome
Interventions
will received lidocaine with dose 250 mg and fentanyl infusion in dose of 200 µg in rate 10ml /hr using 50ml syringe pump.
will receive lidocaine 250 mg in addition to fentanyl injection in dose 100 µg by shots
Sponsors
Assiut University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Masking description
The patients will be randomly allocated to one of two groups; each group consisted of 42 patients. Randomization will be performed using a closed envelope method
Eligibility
Sex/Gender
ALL
Age
18 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
* Patients age from 18 years to 40 years * Both sex * Patients of the American Society of Anesthesiologists (ASA) physical Status class I and II * BMI less than 40
Exclusion criteria
* • Patients who refuse to participate in study. * Uncooperative patients. * Patient with crush injury * Peripheral vascular, neurological or muscle diseases. * Coagulation disorders that affect the blood's clotting activities e.g.: Hemophilia. * History of hypersensitivity to the drugs being evaluated
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| to compare intraoperative pain between systemic and local fentanyl using VAS score | baseline | pain will be assessed using an 11-point (0=no pain and 10=worst pain) VAS scale |
Contacts
Primary ContactAbdelrahman Mostafa Ibrahim Hashim, resident doctor
Backup ContactAhmed Mohamed Elsonbaty, lecturer
Outcome results
None listed