Injury and deformity of the upper extremity can result in dysfunction to nerves, tendons and bones which can lead to disability and pain.
Various techniques of regional anesthesia are frequently used for upper extremity surgery. Specifically, intravenous regional anesthesia, the Bier block, is an effective anesthetic technique. This technique, developed by Dr August Bier in 1908, provides complete anesthesia, a bloodless field, and eliminates the need for general anesthesia. However, it was not until the 1960s that this technique was reintroduced and used in upper extremity surgery due to several disadvantages and reports of major complications. Because of the dose of lidocaine and tourniquet time, there is potential for cardiac and neurological complications such as arrhythmias, seizures, and compartment syndrome the aim of this study To evaluate the effect of Systemic Fentanyl Infusion compared to addition of Fentanyl as An Adjuvant to Lidocaine in Bier Block for Controlling Pain in Patients Undergoing Hand Surgeries
Patients age from 18 years to 40 years
Both sex
Patients of the American Society of Anesthesiologists (ASA) physical Status class I and II
BMI less than 40
• Patients who refuse to participate in study.
Uncooperative patients.
Patient with crush injury
Peripheral vascular, neurological or muscle diseases.
Parallel
Fentanyl infusion
Drugwill received lidocaine with dose 250 mg and fentanyl infusion in dose of 200 µg in rate 10ml /hr using 50ml syringe pump.
Fentanyl Injection
Drugwill receive lidocaine 250 mg in addition to fentanyl injection in dose 100 µg by shots
to compare intraoperative pain between systemic and local fentanyl using VAS score
pain will be assessed using an 11-point (0=no pain and 10=worst pain) VAS scale
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