RESUMEN
Purpose: This study was designed to compare the anesthetic efficacy, post block analgesia, local and systemic related side effects between ropivacaine 0.2% and lidocaine 0.5% when used for forearm intravenous regional anesthesia I.V.R.A.
Patients and Methods: The study comprised 50 patients, allocated randomly into two groups: lidocaine group [gp I] and ropivacaine group [gpII]. Before distal tourniquet deflation, visual analogue pain score [VAS] and verbal rating score [VRS] were recorded at the operative site and at the tourniquet site every [5] minutes until deflation of the distal tourniquet. Tourniquet tolerance was recorded for each patient in both groups, intravenous boluses of fentanyl [25] microgm were given to relieve tourniquet pain with maximum of [3] microgm/ kg through the cannula of the healthy arm and the total dose of fentanyl was recorded for each patient in both groups. Routine monitoring were applied continuously, during surgical procedure [ECG, pulse oximetry, non-invasive blood pressure]. After distal tourniquet deflation [VAS] and [VRS] were recorded every 10 minutes for 90 minutes, sedation score was recorded every 10 minutes for 60 minutes and hemodynamic changes [mean arterial blood pressure] were also recorded every 15 minutes for 45 minutes after distal tourniquet deflation, and any adverse effects of the added drugs were recorded in both groups
Results: The results of this study showed that [VAS] and [VRS] at site of surgery and the tourniquet before distal tourniquet deflation were significantly lower in group II compared with group I, tourniquet tolerance was significantly longer in group II compared with group I, the total dose of fentanyl given to relieve tourniquet pain was significantly lower in group II compared with group I as no patient in group II required fentanyl to relieve tourniquet pain. After distal tourniquet deflation [VAS] and [VRS] were significantly lower in group II compared with group I, sedation score was significantly higher in group I compared with group II as regarding mean arterial blood pressure it did not change significantly in group II compared with group I
Summary and Conclusion: We conclude that ropvicane provides anesthesia and, superior post operative analgesia compared with lidocaine in intravenous regional anesthesia