Axillary plexus block - Dealing with the tourniquet
Research type
Research Study
Full title
Axillary plexus block - Dealing with the tourniquet
IRAS ID
134035
Contact name
Mario Cibelli
Contact email
Sponsor organisation
QEHB
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
The injection of local anaesthetic around the nerves that supply sensation from the arm can provide good and safe pain relief for most procedures on the arm. Unfortunately this technique does not provide adequate pain relief for the tourniquet, which acts as a tight band around the arm to stop blood flow and reduce the risk of bleeding during the operation. Prevention of tourniquet pain was studied in a retrospective cohort study by means of a small injection of local anaesthetic just underneath the skin into the posterior half of the arm pit. The results suggested that this injection could be used to improve patients comfort during such procedures and requires a prospective trial to be performed to confirm this.
We propose to perform a randomised, double blinded case controlled prospective study comparing standard axillary plexus block technique to the same technique with the addition of 3-5ml of local anaesthetic injected subcutaneously in the posterior aspect of the axilla.
We aim to show that the addition of such an injection will result in:
• Improved patient comfort and reduced tourniquet-related pain
• Reduced consumption of sedatives and i.v. analgesics.
• Reduced conversion rate to general anaesthesia.
The use of this method for the prevention of tourniquet pain is becoming widespread despite the current lack of good quality evidence.
An audit performed in our department found that out of 96 axillary plexus blocks performed in a one month period, 92 (96%) had a subcutaneous injection in the posterior half of the axilla in addition to the normal axillary plexus block.
We therefore hope to show that patients are not being unnecessarily exposed to an extra injection that is of no benefit to them.REC name
East Midlands - Nottingham 2 Research Ethics Committee
REC reference
15/EM/0315
Date of REC Opinion
6 Oct 2015
REC opinion
Further Information Favourable Opinion