Research Article

Intravenous Locoregional Anesthesia: An Alternative of Choice in a Country with Limited Resources (Abidjan- Cote d'Ivoire)

Abstract

Background: ALRIV, a simple, reliable, inexpensive and easily reproducible technique, is still little practised in sub-Saharan Africa. The objective of this study is to describe our practice in order to popularize this anesthetic technique.
Methods: This was a prospective and descriptive study covering a 12-month period. All patients admitted for surgical management of upper limb except the arm and lower limb except the thigh were included. The parameters studied were epidemiological, clinical, therapeutic, anaesthetic and evolutionary.
Results: We selected 73 patients out of 675 (10.81%). The majority of the patients were seen in the framework of a regulated surgery against only 13.69% in emergency. The operative indications were: removal of osteosynthesis materials (52.05%), limb osteosynthesis (43.83%) and phlegmon evacuation (4.10%). The double tourniquet technique was used in (93.15%). Lidocaine 0.5% was used at a dose of 0.5ml/kg. The average duration of the procedures was 57.28 minutes. Postoperatively, all our patients received multimodal analgesia. In the postoperative monitoring room, 64.38% of patients did not experience any discomfort or pain.
Conclusion: ALRIV is a simple technique of peripheral local anaesthesia that is easy to teach, consistently effective and inexpensive.

[1]Dupré LJ. Intravenous loco-regional anaesthesia. In Sfar. Ed 36e congrès national d'anesthésie et de réanimation. Paris ; Masson ; 1994 p137-47
[2] Mahmoudi A, Taj A, Boughalem M, Marbout M, Atmani M. Anesthesie Loco-Regionale Intraveineuse Du Membre Superieur A Propos De 194 Cas. Médecine du Maghreb. 2000; 85: 40-1.
[3] Hanafi M, Chani M, Hatim A, Mahmoudi A, Mouden A. Anesthesie Locoregionale Intraveineuse (A Propos De 500 Cas). Rev Maroc Chir Orthop Traumato. 2005; 23: 28-30.
[4] Laxenaire MC, Auroy Y, Clergue F, Péquignot F. Anesthesia in emergency. Ann Fr Anesth Réanim 1998; 17: 1352-62.
[5] Laxenaire MC, Auroy Y, Clergue F, Péquignot F. Anaesthesia for ambulatory patients. Ann Fr Anesth Réanim 1998; 17; 1363-72.
[6] Hoffmann AC, van Gessel E, Gamulin Z, Ryser JE, Forster A. Quantitative evaluation of tourniquet leak during i.v. regional anaesthesia of the upper and lower limbs in human volunteers. Br J Anaesth. 1995; 75(3):269-73.
[7] Marik PE. Aspiration pneumonitis and aspiration pneumonia. N Engl J Med. 2001; 344(9):665-71.
[8] Chilvers CR, Kinahan A, Vaghadia H, Merrick PM. Pharmacoeconomics of intravenous regional anesthesia vs general anesthesia for out patient hand surgery. Can J Anaesth. 1997; 44(11): 1152-6.
[9] Capdevilla X, Ponrouch M, Bilboulet P. Should we forget ALRIV? MAPAR Ed 2008 ALR p. 37
[10] Estèbe JP. Recommendations for the good use of the pneumatic tourniquet in surgery. J.annfar 2006; 25(3): 330-2.
[11] Hartmannsgruber MW, Silverman DG, Halaszynski TM, Bobart V, Brull SJ, Wilkerson C, et al. Comparison of ropivacaine 0.2% and lidocaine 0.5% for intravenous regional anesthesia in volunteers. Anesth Analg. 1999; 89(3):727-31.
[12] Reuben SS, Steinberg RB, Klatt JL, Klatt ML. Intravenous regional anesthesia using lidocaine and clonidine. Anesthesiology. 1999; 91(3):654-8.
[13] Gaumann DM, Brunet PC, Jirounek P. Clonidine enhances the effects of lidocaine on C-fiber action potential. Anesth Analg. 1992; 74(5):719-25.
[14] Deacock ARC, Simpson WT. Fatal reactions to lignocaine, Anesthesia. 1964; 19:217-21.
[15] Koscielniak-Nielsen ZJ, Horn A. Intra-arterial versus intravenous regional analgesia for hand surgery. Anaesthesia. 1993; 48(9):769-72.
[16] Auroy Y, Benhamou D, Bargues L, Ecoffey C, Falissard B, Mercier FJ, et al. Major complications of regional anesthesia in France: The SOS Regional Anesthesia Hotline Service. Anesthesiology. 2002; 97(5):1274-80.
[17] Ware RJ. Intravenous regional anesthesia using bupivacaine. A double blind comparison with lidocaine. Anaesthesia. 1979; 34(3):231-5.
[18] Song D, Chung F. Fast-tracking in ambulatory anesthesia. Can J Anaesth. 2001; 48(7):622-5.
[19] Binhas M, Marty J. Systemic analgesia for post operative pain management in the adult. J Chir 2009; 146(1) :15-23.
[20] Fuzier R, Tissot B, Mercier-Fuzier V, Barbero C, Caussade D, Mengelle F, et al. Evaluation of the use of locoregional anaesthesia in an emergency department. Ann Fr Anesth Réanim 2002; 21(3):193-7.
Files
IssueVol 8 No 3 (2022): Summer QRcode
SectionResearch Article(s)
DOI https://doi.org/10.18502/aacc.v8i3.9606
Keywords
Anaesthesia Locoregional Intravenous
Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Mobio NMP, Kouame KI, Francis N, Bouh KJ, Konan KJ, Soro L. Intravenous Locoregional Anesthesia: An Alternative of Choice in a Country with Limited Resources (Abidjan- Cote d’Ivoire). Arch Anesth & Crit Care. 2022;8(3):183-187.