Comparison of two different methods of limb exsanguination (Esmarch bandage and limb elevation) in intravenous regional anesthesia

Study Objective: To compare the effect of the Esmarch bandage and limb elevation techniques in quality of painlessness of intravenous (IV) regional anesthesia. Design: Double-blinded, controlled, randomized clinical trial. Setting: Operating room of university hospital. Patients: 70 ASA physical status I and II patients who were scheduled for repair of upper extremity soft-tissue injuries. Interventions: Patients were randomized for exsanguination of their upper extremities either by Esmarch bandage (Esmarch group) or by limb elevation (elevation group) to 90 degrees for about 5 minutes. Measurements: Preoperative and intraoperative pain intensities were evaluated by verbal response scale. The intensity of pain and need for IV sedative and analgesic medications were compared in both groups by Fisher's exact and chi(2) tests. Main Results: There was no significant statistical difference between the pain intensity data of two groups either before or after starting the surgery. The need for IV supplemental drugs for pain relief was similar in both groups. Conclusion: The limb elevation technique, while producing less discomfort for patients, can be as effective as the Esmarch bandage in limb exsanguination during IV regional anesthesia. (c) 2008 Elsevier Inc. All rights reserved.