مقایسه اثرات ترکیب "فنتانیل + لیدوکائین + پاولون" با لیدوکائین در بیحسی منطقه ای داخل وریدی

  Intravenous regional anesthesia (IVRA) used in procedures below the elbow and below the knee. Lidocaine is the drug most used in this technique but because of it’s complications (CNS and cardiovascular) it is used cautiously and some other replacements have been studied and this study is performed with this aim. In    this study we used fentanyl and pavlon (pancuronium) as adjuancts for lidocaine to reduce its required dose and compare the effect of this combination with lidocaine alone in IVRA.           In this double blind clinical trial study , fifty-four patients candidated for orthopedic procedures in ASA class I, II were selected and divided randomly in two equal groups each of them had twenty-seven patients. Lidocaine (200 mg in volume of 40 cc) was injected in one group and combination of lidocaine (100mg)    fentanyl (0.05mg)- pavlon (0.5 mg) in volume of 40Cc was injected in the other group. Then the following parameters were discussed and recorded:    The time of onset of block (by pinprick test) , the length of operation , the time of opening the first and second tourniquets , the quality of block , the time of pain returning , the length of postoperative analgesia-patient and surgeon satisfaction.    Thereafter the obtained parameters from each group were analyzed with Epi info 6 software.           Success rate was the same in both groups. The quality of block , and patient and surgeon satisfaction were same in both groups and statistically were not significant. In lidocaine group the average time of onset of block (5.3min) was less than those of lidocaine- fentanyl - pavlon group (7.7 min)(P=0.0008). However the  average time of operation was same in both groups. The average time of postoperative returning of pain inlidocaine fentanyl-pavlon group (15.5 min) was greater than lidocaine group (6.6min) (P=0.0001).           In regard of the lack of difference between two , we can conclude that using this combination (with lidocaine dose half of the other group) is preferred to lidocaine alone (with complete dose) and the rate of complication will reduce.