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

Study ObjectiveTo compare the effect of the Esmarch bandage and limb elevation techniques in quality of painlessness of intravenous (IV) regional anesthesia.DesignDouble-blinded, controlled, randomized clinical trial.SettingOperating room of university hospital.Patients70 ASA physical status І and П patients who were scheduled for repair of upper extremity soft-tissue injuries.InterventionsPatients were randomized for exsanguination of their upper extremities either by Esmarch bandage (Esmarch group) or by limb elevation (elevation group) to 90° for about 5 minutes.MeasurementsPreoperative 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 χ2 tests.Main ResultsThere 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.ConclusionThe limb elevation technique, while producing less discomfort for patients, can be as effective as the Esmarch bandage in limb exsanguination during IV regional anesthesia.