The analgesic effect of nitroglycerin added to lidocaine on quality of intravenous regional anesthesia in patients undergoing elective forearm and hand surgery

Acta Cir Bras. 2013 Jan;28(1):19-25. doi: 10.1590/s0102-86502013000100004.


Purpose: To evaluate the effect of nitroglycerine (NTG) on sensory and motor block onset and recovery time as well as the quality of tourniquet pain relief, when added to lidocaine (LID) for intravenous regional anesthesia in elective forearm and hand surgery.

Methods: A randomized double-blinded clinical trial was performed on 40 patients that were randomly allocated into two groups received lidocaine 3 mg/kg with NTG 200 µg or received only lidocaine 3 mg/kg as the control.

Results: There was no difference between the two study groups in hemodynamic parameters before tourniquet inflation, at any time after inflation and after its deflation. There was no difference in the mean of pain score over time between the two groups. The onset time of sensory and motor blockades was shorter in the group received both LID and NTG. The mean recovery time of sensory blockade was longer in the former group. The frequency of opioid injections was significantly lower in those who administered LID and NTG.

Conclusion: The adjuvant drug of NTG when added to LID is effective in improving the overall quality of anesthesia, shortening onset time of both sensory and motor blockades, and stabling homodynamic parameters in hand and forearm surgery.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adjuvants, Anesthesia / administration & dosage*
  • Adolescent
  • Adult
  • Aged
  • Anesthesia, Intravenous / methods*
  • Anesthetics, Local / administration & dosage*
  • Elective Surgical Procedures / methods
  • Female
  • Forearm / surgery*
  • Hand / surgery*
  • Hemodynamics / drug effects
  • Humans
  • Lidocaine / administration & dosage*
  • Male
  • Middle Aged
  • Nitroglycerin / administration & dosage*
  • Pain Measurement
  • Reproducibility of Results
  • Time Factors
  • Young Adult


  • Adjuvants, Anesthesia
  • Anesthetics, Local
  • Lidocaine
  • Nitroglycerin