WITHDRAWN The analgesic effect of paracetamol when added to lidocaine for intravenous regional anesthesia.

Ahead of Print article withdrawn by publisher AIM: Intravenous regional anesthesia (IVRA) is frequently used in patients who will undergo upper extremity surgical operations for its ease of use, rapid effectiveness and short hospitalization period. Different drug combinations have been used to overcome some systemic adverse effects and to increase the postoperative analgesic effectiveness. In our study, we evaluated the effects of paracetamol (Perfalgan) when added to lidocaine for IVRA, looking specifically at tourniquet pain and postoperative pain. METHODS: Ninety patients undergoing elective hand surgery with IVRA were randomly assigned to three groups to receive either IV saline and C-IVRA with 0.5% lidocaine 3 mg/kg (control group, N=30), IV saline and IVRA with 0.5% lidocaine and 20 mL paracetamol (10 mg/cc) (P-IVRA group, N=30) or IV paracetamol and IVRA with 0.5% lidocaine (L-IV group, N=30). The following were measured: 1) sensory and motor block onset and recovery time, 2) tourniquet pain after tourniquet application and at 10, 20 and 30 min after tourniquet deflation, 3) the visual analog scale (VAS) scores of tourniquet pain at 30 min and 1, 2, 4, 6 and 24 h postoperatively, 4) the time to first analgesic requirement, 5) total analgesic consumption in 24 h and 6) side effects. RESULTS: Sensory and motor block onset and recovery times were similar in both groups. VAS scores of tourniquet pain were lower in group P-IRVA at 1, 2, 4, 6, and 24 h, postoperatively (P<0.01). Anesthesia quality, as determined by the anesthesiologist and surgeon, was similar in both groups. The time to the first postoperative analgesic request was 67.83±57.48 min in group C-IRVA and 93±80.79 min in group P-IRVA (P<0.05). Paracetamol consumption was significantly less in group P-IRVA (1.60± 1 [tablets]) when compared with group C-IRVA (2.45±0.9; P<0.05). CONCLUSIONS: Perfalgan as an adjunct to lidocaine improves postoperative analgesia in IVRA without adverse effects.