Schiller M G
Clin Orthop Relat Res. 1976 Jul-Aug(118):25-9.
Intravenous regional anesthesia for the treatment of fractures and dislocations of the upper extremity is a very effective, consistent and safe form of analgesia which requires low doses of lidocaine and can be performed in an emergency room using a regular blood pressure cuff. Dosage should be related to body weight and the blood pressure cuff should be maintained at higher than systolic pressure for a minimum of 15 minutes after the lidocaine is injected. Release of the tourniquet should be staged as described. Ninety-one per cent of 77 patients had excellent analgesia following the IVRA. Eight per cent had fair results, but this was still adequate to perform the reduction with only minimal but definite discomfort to the patient. Only one patient failed to respond to the IVRA technique. Other advantages such as muscle relaxation during the anesthetic and rapid full return of sensation after cuff release, permit ease of reducion and early anticipation of cast discomfort or pressure pain from sharp edges of plaster. Unpleasant long term side effects of axillary block anesthesia, such as persistent paresthesia have not been seen.
静脉区域麻醉用于治疗上肢骨折和脱位是一种非常有效、可靠且安全的镇痛方式，它所需的利多卡因剂量较低，可在急诊室使用常规血压袖带进行操作。剂量应与体重相关，在注射利多卡因后，血压袖带应维持在高于收缩压的水平至少15分钟。止血带的松开应按所述步骤进行。77例患者中有91%在静脉区域麻醉后获得了极佳的镇痛效果。8%的患者效果尚可，但这仍足以进行复位操作，患者仅有轻微但明确的不适。只有1例患者对静脉区域麻醉技术无反应。其他优点包括麻醉期间肌肉松弛以及止血带松开后感觉迅速完全恢复，这便于进行复位操作，并能早期察觉石膏边缘的不适感或压迫性疼痛。尚未发现腋路阻滞麻醉令人不快的长期副作用，如持续性感觉异常。
