Intravenous regional anaesthesia (ivra): Addition of atracurium or ketorolac to lignocaine-a prospective randomised double blind study

Background: To study the advantages of using NSAID (Ketorolac) or a muscle relaxants (Atracurium) with lignocaine for IVRA in patients posted for upper limb surgeries. Patients and Methods: Sixty adult patients of ASA physical status I and II divided into three equal groups. Group A patients received 40 ml of 0.5% lignocaine diluted in normal saline intravenously. Group B and C patients also received 0.5% lignocaine diluted in normal saline, with addition of 2 mg of Atracurium (Group B) or 30 mg of Ketorolac (Group C) to a total volume of 40 ml. Incidence of tourniquet Pain, intra operative muscle relaxation and analgesic requirement in post operative periods were compared between the groups. Results: Demographic data, hemodynamic changes and tourniquet pain quality were comparable in all groups. Post operative pain free periods in group C patients were considerably high (338.70 ± 236.72 minutes VS 27.8 ± 21.85 (group A) VS 71.20 ± 73.27 minutes (group B); p <0.001) and also required significantly less number of oral analgesics doses (0.35 ± 0.67doses VS 1.20 ± 0.69 (group A) VS 1.15 ± 0.81 doses (group B); p<0.001). Conclusions: Addition of Ketorolac 30 mg to lignocaine for IVRA significantly decreased the analgesic requirements in the post operative periods.