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Fentanyl and Lidocaine versus Lidocaine for Bier Block
  1. Jeff M. Arthur, M.D.*,
  2. Tan Mian, M.B., CH.B., F.F.A.R.C.S.,
  3. James E. Heavner, D.V.M., PH.D.** and
  4. Per H. Rosenberg, M.D., PH.D.
  1. **From the Departments of Anesthesiology and Physiology, Texas Tech University Health Sciences Center, Lubbock, Texas, and the
  2. University of Helsinki, Helsinki, Finland.
  3. *Resident.
  4. **Professor and Director of Research.
  5. Visiting Assistant Professor (Current Address: Heath Cardriff, England).
  6. Professor.
  1. Address correspondence to Jeff M. Arthur, M.D., Department of Anesthesiology, Texas Tech University Health Sciences Center, Lubbock, TX 19430.


Background and Objectives. The present study was designed to assess the efficacy of fentanyl combined with dilute lidocaine solution for intravenous regional anesthesia of the arm.

Methods. In ten volunteers, the nondominant arm was exposed to three treatments: 100 mg lidocaine, 42 ml; 100 mg lidocaine plus 100 μg fentanyl, 42 ml; and 100 μg fentanyl, 42 ml. Each subject was tested on three occasions with three or more days between experiments. Sensory and motor function was tested to determine whether the neural effects of the particular treatments differed.

Results. When lidocaine and lidocaine plus fentanyl results were compared, no significant differences were found. However, anesthesia, analgesia, and loss of motor function generally were less complete and slower in onset with the fentanyl alone treatment. Two subjects became nauseated after tourniquet cuff deflation when lidocaine plus fentanyl was tested, as did one subject when fentanyl was tested.

Conclusion. Results of this and other studies indicate there is no value in adding fentanyl to local anesthetics for intravenous regional anesthesia.

  • Anesthetic techniques
  • intravenous
  • regional
  • Bier block
  • anesthetics
  • local
  • lidocaine
  • opioids
  • fentanyl.

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  • Presented in part at the annual meeting of the American Society of Anesthesiologists, Las Vegas, October 19-23, 1990.

    The authors thank Linda Boggs for secretarial assistance and Varsha Sanghani and Andrew Bessire for technical support of this study.