Addition of atracurium to lidocaine for intravenous regional anaesthesia.

This study was undertaken to examine the possible clinical advantages of using muscle relaxant with intravenous regional anaesthesia, (IVRA). Forty unpremedicated adult patients undergoing hand surgery were randomly allocated to receive either 40 ml 0.5% lidocaine or 40 ml 0.5% lidocaine with 2 mg of atracurium. The atracurium group of patients had a significantly greater degree of muscle relaxation, easier reduction of fractures, and better operative conditions (P < 0.01). Less pain was also reported during surgery (P < 0.025), and 5 and 15 min after release of the tourniquet (P < 0.01). Clinically, there was no difference in the speed of onset of block between the two groups. It is concluded that the addition of atracurium to lidocaine improves the operating condition during IVRA with less pain during and after surgery.