Clinical Research Article Korean J Anesthesiol 2010 Apr; 58(4): 357-361 DOI: 10.4097/kjae.2010.58.4.357 Comparison of the effects of acetaminophen to ketorolac when added to lidocaine for intravenous regional anesthesia Myoung Jin Ko, Jeong Han Lee, Soon Ho Cheong, Chee Mahn Shin, Young Jae Kim, Young Kyun Choe, Kun Moo Lee, Se Hun Lim, Young Hwan Kim, Kwang Rae Cho, and Sang Eun Lee Department of Anesthesiology and Pain Medicine, Busan Paik Hospital, College of Medicine, Inje University, Busan, Korea Background: This study was done to evaluate the effect on pain relief when acetaminophen was added to lidocaine for intravenous regional anesthesia (IVRA). Methods: Sixty patients undergoing hand or forearm surgery received IVRA were assigned to three groups: Group C received 0.5% lidocaine diluted with 0.9% normal saline to a total volume of 40 ml (n = 20), Group P received 0.5% lidocaine diluted with intravenous acetaminophen 300 mg to a total volume of 40 ml (n = 20) and Group K received 0.5% lidocaine diluted with 0.9% normal saline plus ketorolac 10 mg made up to a total volume of 40 ml (n = 20). Sensory block onset time, tourniquet pain onset time, which was defined as the time from tourniquet application to fentanyl administration for relieving tourniquet pain and amount of analgesic consumption during surgery were recorded. Following deflation of tourniquet sensory recovery time, postoperative pain and quantity of analgesic uses in post-anesthesia care unit were assessed. Results: Sensory block onset time was shorter in Group P compared to Group C (P < 0.05). Tourniquet pain onset time was delayed in Group P when compared with group C (P < 0.05). Postoperative pain and analgesic consumption were reduced in Group P and Group K compared to Group C (P < 0.001). Conclusions: The addition of acetaminophen to lidocaine for IVRA shortens the onset time of sensory block and delays tourniquet pain onset time, but not with ketorolac. Both acetaminophen and ketorolac reduce postoperative pain and analgesic consumption. (Korean J Anesthesiol 2010; 58: 357-361) Key Words: Acetaminophen, Intravenous regional anesthesia, Ketorolac, Paracetamol. Received: November 27, 2009. Revised: 1st, December 28, 2009; 2nd, January 22, 2010. Accepted: February 27, 2010. Corresponding author: Jeong Han Lee, M.D., Department of Anesthesiology and Pain Medicine, Busan Paik Hospital, College of Medicine, Inje University, Gaegeum-dong, Busanjin-gu, Busan 614-110, Korea. Tel: 82-51-890-6520, Fax: 82-51-898-4216, E-mail: ljh646@hanmail.net This work was supported by the 2008 Inje University Research Grant. CC This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright ⓒ Korean Society of Anesthesiologists, 2010 www.ekja.org