Comparing the Effect of Nitroglycerine and Dexamethasone as Adjuvants in Intravenous Regional Anesthesia: A Randomized Clinical Trial

Abstract

Background: Previous studies evaluated the effects of adding nitroglycerin and dexamethasone to lidocaine on the quality of the intravenous regional anesthesia (IVRA). However, no comparison was so far made between the two drugs when they are used as adjuvants in intravenous regional anesthesia. This study was designed to compare the effects of adding nitroglycerin or dexamethasone to lidocaine on the quality of intravenous regional anesthesia. Methods: In a prospective randomized double-blinded clinical trial study, 90 patients, with the classes I and II of American Society of Anesthesiologists (ASA) grading, undergoing hand or forearm surgery were randomly allocated into three groups of lidocaine (lidocaine + placebo), dexamethasone (lidocaine + dexamethasone), and nitroglycerin (lidocaine + nitroglycerin). The onset and the recovery times from sensory and motor blocks, the starting time of tourniquet pain, the amount of narcotics required during patients’ recovery, and probable side effects were all recorded and compared between the three groups. Findings: The onsets of sensory and motor blocks occurred earlier in dexamethasone and nitroglycerin groups in comparing to lidocaine group (P 0.05). No significant variations were detected in gender, age, and duration of operations among the study groups (P > 0.05). Conclusion: Adding dexamethasone to lidocaine in intravenous regional anesthesia improves the quality of anesthesia more than nitroglycerin and placebo.

Keywords

• Dexamethasone
• Nitroglycerine
• Lidocaine
• Anesthesia
• Regional
• Intravenous