Anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Intravenous regional analgesia using bupivacaine. A double blind comparison with lignocaine.
A double-blind comparison of bupivacaine and lignocaine for intravenous regional analgesia (Bier's block) was carried out in seventy-two patients presenting for upper limb surgery. Thirty-eight patients received lignocaine and thirty-four received bupivacaine. ⋯ The degree of both analgesia and muscle relaxation was significantly better in the bupivacaine group. Adverse effects were seen only in patients who had received lignocaine and these were unrelated to the tourniquet time.
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The authors have described a fatal complication which occurred after a cervical subarachnoid block with phenol in glycerine. As a result of this experience they advocate the use of a dose of phenol of not more than 2 ml, which is smaller than that sometimes recommended, and also emphasise most strongly the importance of careful positioning of the patient.