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Comparison of two different anesthesia techniques for tourniquet pain with the use of forearm tourniquet.

PURPOSE
The purpose of this prospective, randomized study was to compare the effectiveness of two different anesthesia techniques for tourniquet pain in minor surgeries of the hand with the use of the forearm tourniquet.


METHODS
In group 1, the area under the tourniquet was anesthetized circumferentially using a cream composed of 5% lidocaine and 5% prilocaine (Emla Astra). In group 2, the area under the tourniquet was anesthetized with a ring-type infiltration of the skin and subcutaneus tissues using 50% diluted Citanest solution using 22 G x 3 1/2'' size spinal needle (Sujia) with three injections.


RESULTS
There were no statistically significant differences between the means of the two groups with respect to both tests (p value = 0.18 [t-test], p = 0.951 [Mann-Whitney test]). Tourniquet related anesthesia technique discomfort was higher in group 2 (p = 0.001).


CONCLUSIONS
The tourniquet placed at the distal forearm is an effective, safe, and useful technique for hand surgery. Anesthesia using Emla cream is equally effective and less disturbing than using the injection technique (subcutaneus ring anesthesia).