Single sterile silicon ring technique for utilization of upper limb intravenous regional anesthesia: A prospective study of patients with operated distal radius fractures

Introduction: Intravenous regional anesthesia is a well-established method of anesthesia in upper ex-tremity surgery. In this study, we present a modification of the technique using a silicon ring tourniquet in 30 patients undergoing internal fixation for distal radius fractures. Methods: A sterile silicone ring wrapped within a stockinette sleeve was applied, and a local anesthetic solution (3 mg/kg lidocaine 0,5%) was injected intravenously. After anesthesia onset, the ring was rolled distally to provide immediate pain and discomfort relief. Results: The silicone ring achieved adequate exsanguination in all patients. Mean pain VAS score was 2.7 +/- 0.9 intraoperatively and 4.3 +/- 1.3 during the first hour postoperatively. The onset and termi-nation times of sensory block were 5.8 +/- 2.1 and 102 +/- 7.8 min, and of motor block 13.8 +/- 2.8 and 54.2 +/- 4.6 min, accordingly. All patients were satisfied from the procedure. Conclusion: Sterile silicone ring tourniquet application is a simple, safe and effective analgesic and anes-thetic technique for the operative treatment of distal radius fractures. (c) 2021 Elsevier Ltd. All rights reserved.