Abstract
Purpose
To describe a modified approach to intravenous regional anesthesia (IVRA) for operations on the knee joint.
Clinical features
A 52-yr-old male presenting for knee arthroscopy was anesthetized by IVRA using only 40 mL of lidocaine 0.5%. After performing IVRA in the routine way an additional below knee tourniquet was used and inflated after local anesthetic exsanguination towards the knee. Operation was performed without the need for further analgesic.
Conclusion
The technique allowed the use of a small anesthetic volume for IVRA on the lower limb, thus decreasing the potential risk of local anesthetic toxicity.
Résumé
Objectif
Décrire une approche modifiée de l’anesthésie régionale intraveineuse (ARIV) pour l’arthroscopie du genou.
Éléments cliniques
Un homme de 52 ans devant subir une arthroscopie du genou a reçu une ARIV avec 40 mL de lidocaïne à 0,5 %. Après avoir réalisé l’ARIV de façon courante, un garrot supplémentaire a été appliqué sous le genou et gonflé après l’exsanguination. On a ensuite injecté l’anesthésique local vers le genou. L’opération n’a pas nécessité d’analgésique supplémentaire.
Conclusion
La technique a permis d’utiliser un petit volume d’anesthésique pour l’ARIV du membre inférieur, ce qui réduit le risque potentiel de toxicité à l’anesthésique local.
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References
Estebe JP. Locoregional intravenous anesthesia. Ann Fr Anesth Reanim 1999; 18: 663–73.
Chilvers CR, Kinahan A, Vaghadia H, Merrick PM. Pharmacoeconomics of intravenous regional anaesthesia vs general anaesthesia for outpatient hand surgery. Can J Anaesth 1997; 44: 1152–6.
Henderson CL, Warriner CB, McEwen JA, Merrick PM. A North American survey of intravenous regional anesthesia. Anesth Analg 1997; 85: 858–63.
Blanc VF, Haig M, Troli M, Sauve B. Computerized photoplethysmography of the finger. Can J Anaesth 1993; 40: 271–8.
Brown EM, McGriff JT, Malinowski RW. Intravenous regional anaesthesia (Bier block): review of 20 years’ experience. Can J Anaesth 1989; 36: 307–10.
Davies JA II, Hall ID, Wilkey AD, Smith JE, Walford AJ, Kale VR. Intravenous regional analgesia. The danger of the congested arm and the value of occlusion pressure. Anaesthesia 1984; 39: 416–21.
Hannington-kiff JG. Bier’s block revisited: intercuff block. J RSoc Med 1990; 83: 155–8.
Hilgenhurst G. The Bier block after 80 years: a historical review. Reg Anesth 1990; 15: 2–5.
Lai YY, Chang CL, Yeh FC. The site of action of lidocaine in intravenous regional anesthesia. Ma Zui Xue Za Zhi 1993; 31: 31–4.
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Al-Metwalli, R., Mowafi, H.A. A modification of the inter-cuff technique of IVRA for use in knee arthroscopy. Can J Anesth 49, 687–689 (2002). https://doi.org/10.1007/BF03017446
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DOI: https://doi.org/10.1007/BF03017446