The Use of 0.25% Lidocaine with Fentanyl and Pancuronium for Intravenous Regional Anesthesia

The present study was designed to assess the efficacy of fentanyl and pancuronium combined with dilute lidocaine solution for intravenous regional anesthesia of the arm.Forty adult patients undergoing upper limb surgery were randomly allocated to receive either 0.6 mL/kg of 0.5% lidocaine (3 mg/kg) or 0.6 mL/kg of 0.25% lidocaine (1.5 mg/kg) with 1 micro g/kg of fentanyl and 0.5 mg of pancuronium. The onset of sensory and motor blocks was significantly shorter in the 0.5% lidocaine group (P < 0.05). However, no differences in analgesia or motor blockade were found between the two groups at 20 min tourniquet time. Regional anesthesia was considered successful in more than 85% of patients. One patient in the 0.25% lidocaine group experienced a transient diplopia after tourniquet release. Postoperative analgesia time was similar in the two groups. We conclude that the addition of fentanyl plus pancuronium to the lidocaine solution reduces the dose of the local anesthetic and possibly systemic toxicity. (Anesth Analg 1997;84:777-9)