Background: Pneumatic arterial tourniquet is a utilized strategy in limb surgeries\nto provide bloodless field to facilitate surgical procedure. Be that as it\nmay, arterial tourniquet has numerous injurious impacts including hemodynamic\nchanges and tourniquet-induced pain which sometimes can be severe\nand intolerable. Objectives: Our primary aim was to assess the impact of\nperforming ââ?¬Å?Lumbar Plexus Block and sciatic nerve blockââ?¬Â with General Anesthesia\n(GA) on the degree of arterial tourniquet-induced hemodynamic effects.\nOn the other hand, our secondary aims were: amount of postoperative\nanalgesic prerequisites, patient satisfactory score and documented side effects.\nSettings and Design: Ain Shams University, Orthopedic operating theatre; a\nprospective, randomized, double-blind study. Methods and Material: The\nphysical status of 50 patients (both sexes) including I and II patients from\nAmerican Society of Anesthesiologists, whose ages are from 20 - 40 years, is not\nso ideal when they are undergoing elective knee Arthroscopy. The duration lasts\nno more than ninety minutes under GA with application of tourniquet. Patients\nwere allotted haphazardly to one of two groups. In Group C (Control group):\nOnly GA. In Group B: LPB and sciatic nerve block were performed just before\nGA administration. Intraoperative hemodynamics was recorded at specific timings.\nResults: Incidence of tourniquet induced hypertension (TIH) was markedly\nless with Group B at: forty five, sixty, seventy five mins after tourniquet inflation\nand just before tourniquet deflation. Also, the total ketorolac consumption\nduring first 24 hours of postoperative period was significantly less with\nGroup B (p < 0.001). Finally, patient satisfaction was significantly higher in\nGroup B. Conclusions: Combined Sciatic-Lumbar plexus blocks when combined\nwith general anesthesia were very effective in attenuating TIH.
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