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Background: Perfect pain management is one of the most essential problems in anesthesia. Intravenous block is considered a simple anesthetic method to reduce extremity pain. This study is aimed to determine the effect of proximal injection compared with distal injections to avoid the problems related to be in the vicinity of the surgical field and making use of the larger proximal veins instead of the tiny distal vessels. Methods: In this randomized double blind clinical trial, the patients with traumatic injuries of upper extremities referred to Rajaie Hospital from October 2003 to February 2004 were studied. The cases were divided blindly in to two groups. In one group injections were performed proximally and for the second group distally. Results: This study was based on the data from 100 serial patients. The average time to achieve analgesia was 4.17 + 0.57 minutes for the patients who received distal injections and for the cases that had proximal injection the mean time for analgesia was 5.19 + 0.55. There was no difference in the rate of haematoma formation between the two groups. Conclusions: In intravenous nerve block, the injection of local anesthetic agents in the proximal parts of the limbs is a safe method and is considered as effective as distal injections.

Comparison of Proximal Injections of Local Anesthetics with Distal Injections in Intravenous Block