Babol University of Medical Sciences Caspian Journal of Surgery 3115-9087 1 3 2025 09 01 Comparison of the Effect of Intravenous Regional Anesthesia with Single-Cuff Forearm and Upper Arm Tourniquets on Pain in Patients Undergoing Elective Hand Surgery 151 156 730112 10.22088/caspjs.2025.2067262.1027 EN Nadia Banihashem Department of Anesthesiology, School of Medicine, Babol University of Medical Sciences, Babol, Iran. 0000-0003-4706-9147 Masoume Mosavi Tabarkani Student Research committee, Babol University of Medical Sciences, Babol, Iran. 0000-0001-9330-0851 Shahram Seyfi Department of Anesthesiology, Clinical Research Development Unit of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran. 0000-0002-6554-3693 Ebrahim Alijanpour Department of Anesthesiology, School of Medicine, Babol University of Medical Sciences, Babol, Iran. 0000-0001-6832-5774 Journal Article 2025 07 28 Background: Intravenous regional anesthesia(IVRA), also known as a Bier block, is an effective anesthetic technique for upper limb surgery. This study aimed to compare the efficacy of IVRA using a single-cuff tourniquet on the forearm versus a single-cuff tourniquet on the upper arm in patients undergoing elective hand surgery. <br><br>Methods: In this randomized controlled trial, sixty patients(ASA I-II) scheduled for elective upper limb surgery were randomly allocated into two groups of 30 people. The intervention group received IVRA with a single-cuff forearm tourniquet and 100mg lidocaine injection. The control group received IVRA with a single-cuff upper arm tourniquet and 200mg lidocaine injection. Pain intensity at the surgical and tourniquet sites was assessed using the Visual Analog Scale(VAS) at baseline and intraoperatively.<br><br>Results: A total of 60 patients the onset of analgesia was significantly faster in the Upper Arm Group(6.17±2.52 vs. 7.67±2.25minutes,p=0.019). Surgical site pain was significantly higher in the Upper Arm Group at 90minutes (1.3±0.54 vs. 1.07±0.25,p=0.028) and immediately after surgery (1.3±0.48 vs. 1.1±0.3,p=0.03). Tourniquet pain increased over time in both groups (p<0.0001), but there was no significant difference between the groups (p=0.814). There were no significant differences in patient characteristics, surgery duration, or type of anesthesia between the two groups (p>0.05).<br><br>Conclusion: For procedures lasting up to 30minutes,IVRA with a single-cuff forearm tourniquet and 100mg lidocaine provides analgesia comparable to the upper arm technique with 200mg lidocaine. Considering the side effect of lidocaine, a single-cuff forearm tourniquet technique may be preferred method due to its lower used of lidocaine. https://www.caspjs.com/article_730112_f0f8e1a9e60744c382d1d170f4cfc97a.pdf