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KMID : 0356919680010010053
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Korean Journal of Anesthesiology
1968 Volume.1 No. 1 p.53 ~ p.59
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Intravenous Regional Anesthesia
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金晟烈/Kim, Sung Yell
黃淸子/吳興根/Whang, Chung Ja/Oh, Hung Kun
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Abstract
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Clinical experience using different anesthetic methods for intravenous regional anesthesia in extremities was compared. To group 1 (22 cases, 20 for upper extremity and 2 for lower extremity surgery, with 5 min. limb elevation) 1.5mg/kg Lidocaine hydrochloride was administered and a single pneumatic tourniquet applied. For both group 2 (15 patients, 10 for upper limb and 5 for lower limb operations with limb elevation) and group 3 (II cases, all for upper extremity operations, but Esmarch bandages instead of pre-tourniquet elevation) 3.0 mg/kg Lidocaine hydrochloride was used and a second tourniquet placed distal to the first. In all groups the anesthetic concentration was 0.5 and 0.25 per cent for the upper and lower extremities respectfully. Pneumatic tourniquet pressure applied was 250 mmHg for the upper limb and 500 mmHg for the lower.
Excellent anesthesia resulted in 68.2 per cent in group 1, 73.3 per cent in group 2, and 100 per cent in group 3. No serious complications were encountered. Incidence of incomplete anesthesia and/ or tourniquet pain could be decreased by increasing the anesthetic concentration, using a secondary tourniquet, and by selecting the region to be anesthetized (upper extremities in favor of the lower).
It is concluded that intravenous regional anesthesia is simple, effective and safe and is recommended for ambulatory patients, emergency operations and for patients for whom general anesthesia is deferred.
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