Inventi Impact: Anaesthesiology

Inventi:haa/25828/18

Does the Use of Nitroglycerin Patch Improve Local Anaesthetic Effects in Bierâ??s Block? A Double-\nBlind Placebo Controlled Study

Aim.The aim of the study was to assess the nitroglycerin patch as a new additive to Bierâ��s block and its impact on the effects and\ndose of lidocaine. Methods. Forty patients of each sex belonging to ASA I or II underwent elective tendon repair surgeries of the\nforearm and hand. The patients were divided into two equal groups as follows: Group C received only lidocaine (1.5 mg/kg, 0.25%)\nand Group N received lidocaine (1.5 mg/kg, 0.25%) + 5 mg transcutaneous nitroglycerin patch. Onset and recovery times for\nsensory and motor block, visual analogue scale (VAS) scores for bandage pain, postoperative VAS score, analgesic requirements,\npatientsâ�� satisfaction, and surgeonsâ�� opinion were recorded. Results. Sensory block onset time was shorter in Group N (3.80 �± 1.0)\nthan that in Group C (5.72 �± 1.46), and motor block onset time was shorter in Group N (10.72 �± 1.93) than that in Group C (13.56 �±\n1.26). Sensory block recovery time was prolonged in Group N (10.56 �± 1.12) than Group C (6.88 �± 1.45), recovery time of motor\nblock was prolonged in Group N (13.04 �± 1.57) than Group C (11.96 �± 1.72). Bandage pain had lower VAS scores in Group N.\nPostoperative VAS scores showed significant differences between both groups at the following points of measurement: 30 minutes,\n1 hour, and 4 hours after bandage deflation. Postoperative analgesic effect was the longest in Group N (187.20 �± 60.79 min) than\nGroup C (51.60 �± 25.28 min). Patientsâ�� satisfaction and surgeonsâ�� opinion were better in Group N than Group C. Conclusion.\nSupplementation of Bierâ��s block with transcutaneous nitroglycerin patch reduces the lidocaine dose, the sensory and motor block\nonset times, VAS scores, and analgesic consumption intra- and postoperatively. Length of the block recovery times for the sensory\nand motor effects, duration of postoperative analgesic effect, and the first time to analgesic requirement improved the quality of\nBierâ��s block with better patientsâ�� satisfaction and surgeonsâ�� opinion and had no adverse effects.