A North American Survey of Intravenous Regional Anesthesia

• Published in: Anesthesia and analgesia Vol. 85; no. 4; pp. 858 - 863
• Main Authors: Henderson, Cynthia L, Warriner, C. Brian, McEwen, James A, Merrick, Pamela M
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD International Anesthesia Research Society 01.10.1997; Lippincott
• Subjects: Adult; Aged; Anesthesia; Anesthesia, Conduction - adverse effects; Anesthesia, Conduction - methods; Anesthesia, Intravenous - adverse effects; Anesthesia, Intravenous - methods; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Humans; Local anesthesia. Pain (treatment); Medical sciences; Middle Aged; North America; America; Human; Complication; Survey; Regional anesthesia; Intravenous administration; Technique
• ISSN: 0003-2999; 1526-7598
• DOI: 10.1097/00000539-199710000-00027

One thousand questionnaires concerning the techniques and complications of intravenous regional anesthesia (IVRA) were sent to 900 American and 100 Canadian anesthesiologists.Of the 321 respondents, 86% perform IVRA regularly. A wide variation in devicerelated and clinical aspects was found, ranging from acceptable to falling outside published guidelines. Anesthesiologists perform a median of four upper-limb IVRA procedures per month, most often using 50 mL of lidocaine 0.5% at tourniquet pressures of 250 mm Hg or 100 mm Hg greater than the systolic blood pressure. Forearm, thigh, and calf IVRA are occasionally used. Complications, reported infrequently in the literature, were reported by respondents, including mistaken deflation of the cuff; dysphoria, dizziness, or facial tingling; seizures; cardiac arrests; and deaths. Although there was no correlation between complications and deviation from traditional practice, we recommend that IVRA be performed following recognized protocols by anesthesiologists who are familiar with the technique and trained to treat its potential complications. We recommend a protocol for IVRA. ImplicationsIntravenous regional anesthesia is a widely used anesthetic technique. A survey of 321 American and Canadian anesthesiologists indicates a wide variation in technique. Despite no correlation between complications and technique, the authors recommend that recognized protocols be used for this technique.(Anesth Analg 1997;85:858-63)