now: lidocaine
for surgeries <1 hr
double cuff tourniquet
IV cannula
Esmarch bandage
exsanguinate
inflate distal cuff then proximal cuff then deflate distal cuff
SBP 100mmHg above systolic p
lignocaine through IV cannula (12-15 ml of 2% vs 20ml of 0.5% )
deflate for 10seconds, reinflate 1 min then deflate again
disadvantages:
- tourniquet pain for longer ops
- no post op analgesia
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