Comparison of Duration of Analgesia in the Axillary Block with Lidocaine and Granisetron/Lidocaine Combination in Patients Requiring Lower Elbow Surgery


1 Assistant Professor of Anesthesiology, Clinical Research Development Unit, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran.

2 Otorhinolaryngologist, Clinical Research Development Unit, Shafa Hospital, Kerman University of medical Science, Kerman, Iran.

3 Anesthesiologist, Assistant Professor of Intensive Care, North Khorasan University of Medical Sciences, Bojnourd, Iran.

4 Department of Anesthesiology, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran.


Background: This study aimed to compare the use of lidocaine alone and granisetron/lidocaine combination in terms of the efficacy and continuity of the analgesic effect in the axillary block in patients requiring lower elbow surgery.
Materials and Methods: This study was a double-blind randomized clinical trial performed on candidates for elbow and lower elbow surgery who were considered for the axillary block. An ultrasonography-guided axillary block was performed by a linear transducer using a short-axis view with an in-plane technique. The patient was placed in the supine position with the arms outstretched and turned outwards. The ultrasound image should show the arteries and veins of the axillary branches at the end of the brachial plexus, conjoint tendon, biceps, triceps, and coracobrachialis muscle. The first group received lidocaine, and the second group received a granisetron/lidocaine combination. First, five mg/kg of lidocaine 0.5% was diluted to 40 ml with 0.9% saline. In the first group, 40 ml of lidocaine solution was injected after dipping the syringe in epinephrine. In the second group, two mg of granisetron was injected simultaneously with lidocaine solution administration.
Results: In total, 90 patients were included in the study. The results showed that the onset of sensory and motor block in the second group (granisetron/lidocaine combination) was significantly lower than in the first group (lidocaine alone) (p<0.001). Moreover, the continuity of sensory and motor blocks was significantly higher in the second group (p<0.001).
Conclusion: The concomitant use of granisetron with lidocaine improved all pain indicators in patients. This combination also led to more continuous sensory and motor blocks in a shorter time.