Brazilian Journal of Anesthesiology
https://app.periodikos.com.br/journal/rba/article/doi/10.1016/j.bjane.2014.07.013
Brazilian Journal of Anesthesiology
Scientific Article

Comparison of tramadol and lornoxicam in intravenous regional anesthesia: a randomized controlled trial

Comparação de tramadol e lornoxicam em anestesia regional por via intravenosa, um estudo randomizado e controlado

Hande Çelik; Ruslan Abdullayev; Erkan Y. Akçaboy; Mustafa Baydar; Nermin Gögüs

http://dx.doi.org/10.1016/j.bjane.2014.07.013 Braz J Anesthesiol, vol.66, n1, p.44-49, 2016
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Abstract

BACKGROUND AND OBJECTIVES: Tourniquet pain is one of the major obstacles for intravenous regional anesthesia. We aimed to compare tramadol and lornoxicam used in intravenous regional anesthesia as regards their effects on the quality of anesthesia, tourniquet pain and postoperative pain as well. METHODS: After the ethics committee approval 51 patients of ASA physical status I-II aged 18-65 years were enrolled. The patients were divided into three groups. Group P (n = 17) received 3 mg/kg 0.5% prilocaine; group PT (n = 17) 3 mg/kg 0.5% prilocaine + 2 mL (100 mg) tramadol and group PL (n = 17) 3 mg/kg 0.5% prilocaine + 2 mL (8 mg) lornoxicam for intravenous regional anesthesia. Sensory and motor block onset and recovery times were noted, as well as tourniquet pains and postoperative analgesic consumptions. RESULTS: Sensory block onset times in the groups PT and PL were shorter, whereas the corresponding recovery times were longer than those in the group P. Motor block onset times in the groups PT and PL were shorter than that in the group P, whereas recovery time in the group PL was longer than those in the groups P and PT. Tourniquet pain onset time was shortest in the group P and longest in the group PL. There was no difference regarding tourniquet pain among the groups. Group PL displayed the lowest analgesic consumption postoperatively. CONCLUSION: Adding tramadol and lornoxicam to prilocaine for intravenous regional anesthesia produces favorable effects on sensory and motor blockade. Postoperative analgesic consumption can be decreased by adding tramadol and lornoxicam to prilocaine in intravenous regional anesthesia.

Keywords

Intravenous regional anesthesia, IVRA, Prilocaine, Tramadol, Lornoxicam

Resumo

JUSTIFICATIVA E OBJETIVOS: A dor relacionada ao torniquete é um dos maiores obstáculos para a anestesia regional intravenosa (ARIV). Nosso objetivo foi comparar tramadol e lornoxicam usados em ARIV em relação aos seus efeitos sobre a qualidade da anestesia, dor relacionada ao torniquete e dor no pós-operatório. MÉTODOS: Após a aprovação do Comitê de Ética, 51 pacientes com estado físico ASA I-II entre 18-65 anos foram inscritos. Os pacientes foram divididos em três grupos. Grupo P (n = 17) recebeu 3 mg/kg de prilocaína a 0,5%; Grupo PT (n = 17) 3 mg/kg de prilocaína a 0,5% + 2 mL (100 mg) de tramadol e Grupo PL (n = 17) de 3 mg/kg de prilocaína a 0,5% + 2 mL (8 mg) de lornoxicam para ARIV. O início do bloqueio sensorial e motor e os tempos de recuperação foram registrados, bem como a dor relacionada ao torniquete e o consumo de analgésico no pós-operatório. RESULTADOS: Os tempos de início do bloqueio sensorial foram mais curtos nos grupos PT e PL, enquanto que os tempos de recuperação correspondentes foram mais longos do que os do Grupo P. Os tempos de início do bloqueio motor nos grupos PT e PL foram menores do que no Grupo P, enquanto que o tempo de recuperação do grupo PL foi maior do que os dos grupos P e PT. O tempo para início da dor relacionada ao torniquete foi menor no Grupo P e maior no Grupo PL. Não houve diferença em relação à dor relacionada ao torniquete entre os grupos. O Grupo PL apresentou o menor consumo de analgésicos no pós-operatório. CONCLUSÃO: A adição de tramadol e lornoxicam à prilocaína para ARIV produz efeitos favoráveis sobre o bloqueio sensorial e motor. O consumo de analgésicos no pós-operatório pode ser reduzido com a adição de tramadol e lornoxicam à prilocaína em ARIV.

Palavras-chave

Anestesia regional intravenosa, IVRA, Prilocaína, Tramadol, Lornoxicam

References

Erdine S. Rejyonel Anestezi 2. 2008:104-7.

Davies NJH, Cashman JN. Lee's synopsis of anaesthesia. 1993:428-9.

Kayhan Z. Klinik Anestezi 3. 2004:527-8.

Brill S, Middleton W, Brill G. Bier's block; 100 years old and still going strong. Acta Anaesthesiol Scand.. 2004;48:117-22.

Haasio J, Hiippala S, Rosenberg P. Intravenous regional anaes-thesia of the arm. Anaesthesia.. 1989;44:19-21.

Chan VW, Philip WH, Kaszas Z. A comparative study of general anesthesia, intravenous regional anesthesia and axillary block for outpatient hand surgery: clinical outcome and cost analysis. Anesth Analg.. 2001;93:1181-4.

Yurtlu S, Hanci V, Kargi E. The analgesic effect of dexke-toprofen when added to lidocaine for intravenous regional anaesthesia: a prospective, randomized, placebo controlled study. J Int Med Res.. 2011;39:1923-31.

Hoffmann V, Vercauteren M, Van Steenberge A. Intra-venous regional anesthesia. Evaluation of 4 different additives to prilocaine. Acta Anaesthesiol Belg.. 1997;48:71-6.

Kol IO, Ozturk H, Kaygusuz K. Addition of dexmedeto-midine or lornoxicam to prilocaine in intravenous regional anaesthesia for hand or forearm surgery: a randomized con-trolled study. Clin Drug Invest.. 2009;29:121-9.

Tan SM, Pay LL, Chan ST. Intravenous regional anaesthe-sia using lignocaine and tramadol. Ann Acad Med Singapore.. 2001;30:516-9.

Acalovschi I, Cristea T, Margarit S. Tramadol added to lidocaine for intravenous regional anesthesia. Anesth Analg.. 2001;92:209-14.

Kapral S, Gollmann G, Waltl B. Tramadol added to mepi-vacaine prolongs the duration of an axillary brachial plexus blockade. Anesth Analg.. 1999;88:853-6.

Rosenberg PH. Intravenous regional anesthesia: nerve block by multiple mechanisms. 1992 ASRA Lecture. Reg Anesth.. 1993;18:1-5.

Langlois G, Estebe JP, Gentili ME. The addition of tramadol to lidocaine does not reduce tourniquet and postoperative pain during iv regional anesthesia. Can J Anesth.. 2002;49:165-8.

Sen S, U˘gur B, Aydin ON. The analgesic effect of lornoxicam when added to lidocaine for intravenous regional anesthesia. Br J Anesth.. 2006;97:408-13.

Armstrong P, Brockway M, Wildsmith JAW. Alkalinization of prilocaine for intravenous regional anaesthesia. Anaesthesia.. 1990;45:935-7.

Reuben SS, Duprat KM. Comparison of wound infiltration with ketorolac versus intravenous regional anesthesia with ketorolac for postoperative analgesia following ambulatory hand surgery. Reg Anesth.. 1996;21:565-8.

Deciga-Campos M, Lopez Munoz FJ. Participation of the l-arginine-nitric oxidecyclic GMP-ATP-sensitive K2+ channel cascade in the antinociceptive effect of rofecoxib. Eur J Pharmacol.. 2004;484:193-9.

Dallel R, Voisin D. Towards a pain treatment based on the identification of the pain-generating mechanisms?. Eur Neurol.. 2001;45:126-32.

Jankovic RJ, Visnjic MM, Milic DJ. Does the addition of ketorolac and dexamethasone to lidocaine intravenous regional anesthesia improve postoperative analgesia and tourniquet tolerance for ambulatory hand surgery. Minerva Anesthesiol.. 2008;74:521-7.

Chabel C, Russel LC, Lee R. Tourniquet induced limb ischemia: a neurophysiologic animal model. Anesthesiology.. 1990;72:1038-44.

Rokyta R, Holecek V, Pekárkova I. Free radicals after painful stimulation are influenced by antioxidants and anal-gesics. Neuro Endocrinol Lett.. 2003;24:304-9.

Kanbak O, Sucu Y, Gögüs¸ N. RIVA'da ketorolak ve tenok-sikam kullanimi. Anestezi Dergisi.. 1996;4:38-41.

Steinberg RB, Reuben SS, Gardner G. The dose-response relationship of ketorolac as a component of intravenous regional anesthesia with lidocaine. Anesth Analg.. 1998;86:791-3.

Singh R, Bhagwat A, Bhadoria P. Forearm IVRA, using 0.5% lidocaine in a dose of 1.5 mg/kg with ketorolac 0.15 mg/kg for hand and wrist surgeries. Minerva Anesthesiol.. 2010;76:109-14.

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