Does a wrist tourniquet improve the quality of Biers block for surgeries in the hand?

Abstract

This study aims to determine the effect of a wrist tourniquet on Biers Block quality for short hand procedures. 40 patients were randomized into 2 groups. One had the intravenous lignocaine injected with a wrist rubber tourniquet in situ, While the control group had none during injection. The onset of block, sensation, motor activity, need for additional analgesia and duration of surgeries were recorded for each group and analysed statistically. 27 males and 13 females were recruited. Mean onset for the tourniquet group was 4.3minutes and 9.0 minutes for the control (p< Ë‚0.0000005), Visual analog Pain Scores were 0.2 for Tourniquet and 1.8 for control (p< 0.0003) at 15 minutes. Sensory and motor block scores were significantly higher at 15 minutes following anaesthetic agent administration in the tourniquet group compared to the control(p<0.05). At 30 minutes there was no statistically significant difference in the scores. There was also no difference in the need for additional analgesia in either group. It appears that the use of a wrist tourniquet shortens the onset of Biers block for hand surgeries. However, it does not improve overall block quality after 30 minutes of administration but allowed a smaller dosage to be used with fewer side effects.