Comparison of two different methods of limb exsanguination (Esmarch bandage and limb elevation) in intravenous regional anesthesia.

STUDY OBJECTIVE

To compare the effect of the Esmarch bandage and limb elevation techniques in quality of painlessness of intravenous (IV) regional anesthesia.

DESIGN

Double-blinded, controlled, randomized clinical trial.

SETTING

Operating room of university hospital.

PATIENTS

70 ASA physical status capital I, Ukrainian and capital PE, Cyrillic patients who were scheduled for repair of upper extremity soft-tissue injuries.

INTERVENTIONS

Patients were randomized for exsanguination of their upper extremities either by Esmarch bandage (Esmarch group) or by limb elevation (elevation group) to 90 degrees for about 5 minutes.

MEASUREMENTS

Preoperative and intraoperative pain intensities were evaluated by verbal response scale. The intensity of pain and need for IV sedative and analgesic medications were compared in both groups by Fisher's exact and chi2 tests.

MAIN RESULTS

There was no significant statistical difference between the pain intensity data of two groups either before or after starting the surgery. The need for IV supplemental drugs for pain relief was similar in both groups.

CONCLUSION

The limb elevation technique, while producing less discomfort for patients, can be as effective as the Esmarch bandage in limb exsanguination during IV regional anesthesia.