Effect of Addition of Cisatracurium to Lignocaine versus plain Lignocaine for Intravenous Regional Anesthesia; A Quasi Experimental Study

Objective: To compare the efficacy and safety of the addition of Cisatracurium to Lignocaine versusplain Lignocaine for IVRA. Study Design: Quasi experimental study. Place and Duration of Study: Combined Military Hospital, Rawalpindi Pakistan, from Jun to Dec 2023. Methodology: Forty-four patients undergoing elective hand surgery were randomly assigned to two groups of 22 patients each. All demographic details were noted, all were briefed about VAS (0 to 10) for pain. Group 1 received Lignocaine 2%; Group 2 received Cisatracurium plus Lignocaine 2%. Standard technique was employed for IVRA. Following were assessed: onset and offset of sensory and motor block, quality of anesthesia using a numerical scale scored 1-4, postoperative pain using VAS measured at 5-minute,1, 2, 4, 8 hours and the time to first analgesic request. Results: The onset times of sensory & motor blocks were significantly shorter (p=0.001 & p<0.001) and the regression times of sensory & motor blocks were prolonged (p=0.003 & p<0.001) in group B compared with the group A. The Cisatracurium group had better quality of anesthesia (p<0.001). Overall, lower mean VAS pain scores were recorded after tourniquet deflation and longer time to the first analgesic request (p<0.001) was recorded in Cisatracurium group post-operatively. Conclusion: The addition of Cisatracurium to Lignocaine in IVRA, shortened the block onset times, prolonged the block offset times, improved the quality of anesthesia & decreased the post-operative pain & time to first analgesic requirement.