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Comparing Effects of Lidocaine and Lidocaine-Midazolam in Regional İntravenous Anesthesia

Yıl 2018, Cilt: 40 Sayı: 3, 19 - 24, 01.09.2018
https://doi.org/10.20515/otd.395166

Öz

There is no clear
approach to the ideal agent to be used in regional intravenous anesthesia
(RIVA). Various adjuvants are added to local anesthetic agents to increase the
quality of RIVA and to avoid local anesthetic side effects. The purpose of this
study is to research the effect on block quality in RIVA by adding midazolam to
lidocaine. Patients aged 18-60 years old who underwent upper extremity surgery
were randomly assigned 2 groups. A double-headed tourniquet was placed after
venous drainage by lifting the upper arm. Following inflating the tourniquet,
the control group (Group K) received 3 mg/kg 2%lidocaine and the midazolam
group (Group M) received 3mg/kg lidocaine and 50 µgr/kg midazolam in 40 cc
volume on the arm that will be operated. Tourniquet time, onset and recovery
times of sensory and motor block, intraoperative pain level, and first
postoperative analgesic requirement time were recorded. There was no difference
between the groups in terms of tourniquet time and intraoperative pain levels.
Sensory and motor block onset times were significantly shorter in Group M
(p:0.000). The first postoperative analgesic requirement time was observed
earlier in Group K (Group K:74.678, Group M: 86.123 minute). A quicker onset
anesthesia and analgesia were obtained without any side effects in the RIVA applied
by adding midazolam to the lidocaine.

Kaynakça

  • 1. Flamer D, Peng PWH. Intravenous Regional Anesthesia: A review of comman local anesthetic optins and the use of opioids and muscle relaxants as adjuncts. Local Reg Anesth 2011;4: 57-76
  • 2. Choyce A, Peng P. A systematic review of adjuncts for intravenous regional anesthesia for surgical procedures. Can J Anaesth 2002;49: 32-45
  • 3. Nishiyama T, Tamai H, Hanako K. Serum and cerebrospinal fluid concentrations of midazolam after epidural administrations in dogs. Anesth Analg 2003;96: 159-162
  • 4. Kohno T, Kumamoto E, Baba H, Ataka T. Actions of midazolam on GABAergic transmission in substantia gelatinosa neurons of adult rat spinal cord slices. Anesthesiology 2000;92: 507-515
  • 5. Cairns BE, Sessle BJ, Hu JW. Activations of peripheral GABA-A receptors inhibits tempromandibular joints evoked jaw muscle activity. J Neurophysiol 1999;81: 1966-1969
  • 6. Kontinen VK, D ickenson AH. Effects of midazolam in the spinal nevre ligation model of neuropathic pain in rats. Pain 2000; 85: 425-431
  • 7. Acaloyschi I, Cristea T,Margarit S,Gavrus T. Tramadol added to lidocaine for intravenous regional anesthesia. Anesth Analg 2001;92: 209-214
  • 8. Tan SM, Pay LL, Chan T. Intravenous regional anesthesia using lidocaine and tramadol. Ann Acad Med Singapore 2001;30: 516-519
  • 9. Gupta B, Verma RK, Kumar S, Chaudhary G. Comparison of analgesic efficacy of dexmedetomidine and midazolam as adjuncts to lignocaine for intravenous regional anesthesia. Anesth Essays Res 2017;11: 62-66
  • 10. Turan A, Memiş D, Karamanlıoğlu A, Güler T, Pamukçu Z. Intravenous regional anesthesia using lidocaine and magnesium. Anesth Analg 2005;100:1189-1192
  • 11. Naguib M, el GM, Elhattab YS, Seraj M. Midazolam for caudal analgesia in children: comparison with caudal bupivacaine. Can J Anaesth. 1995;42(9):758–64
  • 12. Chattopadhyay A, Maitra S, Sen S, Bhattacharjee S, Layek A, Pal S, Ghosh K. A study to compare the analgesic efficacy of intrathecal bupivacaine alone with intrathecal bupivacaine midazolam combination in patients undergoing elective infraumblical surgery. Anesthesiology Research and Practise 2013;2013: 567134
  • 13. Goodchild CS, Guo Z, Musgreave A, Gent JP. Antinociception by intrathecal midazolam involves endogenous neurotransmitters acting at spinal cord delta opioid receptors. Br J Anaesth 1996;77(6):758–63
  • 14. Farouk S, Aly A. Quality of lidocaine analgesia with and without midazolam for intravenous regional anesthesia. J Anesth 2010;24: 864-868
  • 15. Kashefi P, Montazeri K, Honarmand A, Safavi M, Hosseini HM. The analgesic effect of midazolam when added to ligocaine for intravenous regional anesthesia. J Res Med Sci 2011;16: 1139-1148
  • 16. Chang KSK, Feng MG, Davis RF. Midazolam procedures vasodilation by mixed endothelium dependent and independent mechanisms. Anesth Analg 1994; 78: 710-717

Rejyonel İntravenöz Anestezide Lidokain ve Lidokain-Midazolamın Etkinliklerinin Karşılaştırılması

Yıl 2018, Cilt: 40 Sayı: 3, 19 - 24, 01.09.2018
https://doi.org/10.20515/otd.395166

Öz

Rejyonel intravenöz
anestezide (RİVA) kullanılacak ideal ajan ile ilgili net bir yaklaşım yoktur.
Lokal anestezik ajanlara çeşitli adjuvanlar eklenerek RİVA kalitesi artırılmaya
ve lokal anestezik yan etkilerinden kaçınılmaya çalışılmaktadır. Bu çalışmada
RİVA sırasında lidokaine eklenen midazolamın blok kalitesi üzerine etkilerinin
araştırılması amaçlanmıştır.Üst ekstremite cerrahisi geçirecek yaşları 18-60
yaş arasındaki hastalar rastgele 2 gruba ayrıldı. Opere olacak kol yukarıya
kaldırılarak venöz boşalma yapıldıktan sonra çift kaflı turnike yerleştirildi,
turnikenin şişirilmesini takiben el sırtındaki venöz kanülden kontrol grubuna
(Grup K) 40 ml volümde 3 mg/kg %2’lik lidokain, midazolam grubuna (Grup M) ise
toplamda 40 ml volümde 3 mg/kg %2’lik lidokain içinde 50 μg/kg midazolam
enjekte edildi. Turnike süresi, oluşan duyusal ve motor blok, duysal ve motor
blok dönme zamanı, intraoperatif ağrı seviyesi ve postoperatif ilk analjezik
ihtiyaç zamanı kayıt edildi.Turnike süresi ve intraoperatif ağrı seviyeleri açısından
gruplar arasında fark saptanmadı. Duysal ve motor blok başlama zamanı Grup M’de
daha kısa bulundu (p:0.000).  Motor blok
dönme zamanı Grup M’de daha kısa idi (p:0.003). Postoperatif ilk analjezik
ihtiyaç zamanının Grup K’da daha önce olduğu gözlendi (Grup K:74.678, Grup M:
86.123 dakika). Lidokaine midazolam eklenerek uygulanan RİVA da herhangi bir
yan etki ile karşılaşılmadan daha hızlı başlangıçlı bir anestezi ve analjezi
elde edilmiştir.

Kaynakça

  • 1. Flamer D, Peng PWH. Intravenous Regional Anesthesia: A review of comman local anesthetic optins and the use of opioids and muscle relaxants as adjuncts. Local Reg Anesth 2011;4: 57-76
  • 2. Choyce A, Peng P. A systematic review of adjuncts for intravenous regional anesthesia for surgical procedures. Can J Anaesth 2002;49: 32-45
  • 3. Nishiyama T, Tamai H, Hanako K. Serum and cerebrospinal fluid concentrations of midazolam after epidural administrations in dogs. Anesth Analg 2003;96: 159-162
  • 4. Kohno T, Kumamoto E, Baba H, Ataka T. Actions of midazolam on GABAergic transmission in substantia gelatinosa neurons of adult rat spinal cord slices. Anesthesiology 2000;92: 507-515
  • 5. Cairns BE, Sessle BJ, Hu JW. Activations of peripheral GABA-A receptors inhibits tempromandibular joints evoked jaw muscle activity. J Neurophysiol 1999;81: 1966-1969
  • 6. Kontinen VK, D ickenson AH. Effects of midazolam in the spinal nevre ligation model of neuropathic pain in rats. Pain 2000; 85: 425-431
  • 7. Acaloyschi I, Cristea T,Margarit S,Gavrus T. Tramadol added to lidocaine for intravenous regional anesthesia. Anesth Analg 2001;92: 209-214
  • 8. Tan SM, Pay LL, Chan T. Intravenous regional anesthesia using lidocaine and tramadol. Ann Acad Med Singapore 2001;30: 516-519
  • 9. Gupta B, Verma RK, Kumar S, Chaudhary G. Comparison of analgesic efficacy of dexmedetomidine and midazolam as adjuncts to lignocaine for intravenous regional anesthesia. Anesth Essays Res 2017;11: 62-66
  • 10. Turan A, Memiş D, Karamanlıoğlu A, Güler T, Pamukçu Z. Intravenous regional anesthesia using lidocaine and magnesium. Anesth Analg 2005;100:1189-1192
  • 11. Naguib M, el GM, Elhattab YS, Seraj M. Midazolam for caudal analgesia in children: comparison with caudal bupivacaine. Can J Anaesth. 1995;42(9):758–64
  • 12. Chattopadhyay A, Maitra S, Sen S, Bhattacharjee S, Layek A, Pal S, Ghosh K. A study to compare the analgesic efficacy of intrathecal bupivacaine alone with intrathecal bupivacaine midazolam combination in patients undergoing elective infraumblical surgery. Anesthesiology Research and Practise 2013;2013: 567134
  • 13. Goodchild CS, Guo Z, Musgreave A, Gent JP. Antinociception by intrathecal midazolam involves endogenous neurotransmitters acting at spinal cord delta opioid receptors. Br J Anaesth 1996;77(6):758–63
  • 14. Farouk S, Aly A. Quality of lidocaine analgesia with and without midazolam for intravenous regional anesthesia. J Anesth 2010;24: 864-868
  • 15. Kashefi P, Montazeri K, Honarmand A, Safavi M, Hosseini HM. The analgesic effect of midazolam when added to ligocaine for intravenous regional anesthesia. J Res Med Sci 2011;16: 1139-1148
  • 16. Chang KSK, Feng MG, Davis RF. Midazolam procedures vasodilation by mixed endothelium dependent and independent mechanisms. Anesth Analg 1994; 78: 710-717
Toplam 16 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm ORİJİNAL MAKALELER / ORIGINAL ARTICLES
Yazarlar

Nurbanu Yaşar Bu kişi benim

Ayten Bilir

Dilek Ceyhan Bu kişi benim

Cemil Sabuncu Bu kişi benim

Yayımlanma Tarihi 1 Eylül 2018
Yayımlandığı Sayı Yıl 2018 Cilt: 40 Sayı: 3

Kaynak Göster

Vancouver Yaşar N, Bilir A, Ceyhan D, Sabuncu C. Rejyonel İntravenöz Anestezide Lidokain ve Lidokain-Midazolamın Etkinliklerinin Karşılaştırılması. Osmangazi Tıp Dergisi. 2018;40(3):19-24.


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