Comparison of RIVA and infraclavicular block in forearm and hand surgery

OBJECTIVE The aim of this study was to compare 2 techniques that are widely used in hand, wrist, and forearm: regional intravenous anesthesia (RIVA) and infraclavicular brachial block. METHODS A total of 100 patients who were aged 18 to 85 years and who underwent hand, wrist, or forearm surgery of at least 30 minutes duration were included. RIVA was applied to Group 1 patients with administration of 40 mL of prilocaine (3 mg/kg). Ultrasonography-guided infraclavicular block was performed on Group 2 patients with 20 mL of 1% prilocaine. Several aspects of these 2 methods were compared, including length of time required to apply anesthesia, the analgesic effectiveness of the treatment during administration and in the peroperative and postoperative periods. RESULTS The rate of mild and complete sensory loss was significantly higher in Group 2 at 10th and 15th minutes than in Group 1. The number scoring less than grade 2 using modified Bromage grading system in Group 2 was considerably greater than in Group 1. Processing time to apply the block was significantly longer in Group 1 compared with Group 2. CONCLUSION It was determined that infraclavicular brachial block is superior to the RIVA method with respect to length of time required to administer and ease of application.