Mam. Simon et al., DISPOSITION OF LIGNOCAINE FOR INTRAVENOUS REGIONAL ANESTHESIA DURING DAY-CASE SURGERY, European journal of anaesthesiology, 15(1), 1998, pp. 32-37
Lignocaine is a suitable and safe agent for intravenous regional anaes
thesia (IVRA) with rapid onset of good surgical anaesthesia. The onset
time of the local anaesthetic action of lignocaine was 11.2+/-5.1 min
. Satisfactory surgical conditions, evidenced by good sensory blockade
were achieved within 20 min, and no additional analgesics were requir
ed. There was no trend towards a fixed sequence, radial, median and ul
nar in the development of sensory blockade. No patient exhibited objec
tive symptoms of toxicity, either local or systemic, after release of
the tourniquet, nor were there any subjective complaints. No changes i
n blood pressure, heart rate or oxygen saturation were observed at any
time during the procedure, or after deflation of the tourniquet. Afte
r releasing the tourniquet lignocaine is rapidly and biexponentially e
liminated, with a t(1/2a) of 4.3+/-2.1 min and a t(1/2 beta) of 79.1+/
-31.2 min. Total body clearance was 0.86+/-0.39L min(-1). Eight patien
ts showed rapid release of lignocaine from the exsanguinated area. in
two patients the systemic plasma concentration of lignocaine increased
more slowly than in the remaining eight. This can be explained by a g
reater degree of lignocaine absorbtion in the tissues of the arm. Phar
macokinetic constants after rapid and slow absorption were calculated.