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Effectiveness of USG Guided Axillary Ring Block in Reducing Tourniquet Pain in Patients Undergoing Upper Extremity Surgery With Supraclavicular Brachial Plexus Block

Rayees Najib , Rayees Najib1 , Umer Iqbal Peer2 , Ruksana Najeeb3

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Indian Journal of Anesthesia and Analgesia 7(5):p 1125-1130, September – October 2020. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.7520.37

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Rayees Najib, Umer Iqbal Peer, Ruksana Najeeb. Effectiveness of Usg Guided Axillary Ring Block in Reducing Tourniquet Pain in Patients Undergoing Upper Extremity Surgery With Supraclavicular Brachial Plexus Block. Indian J Anesth Analg. 2020;7(5):
1125–1130
 

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Received : N/A         Accepted : N/A          Published : N/A

Abstract

Background: Brachial plexus block has evolved as an important tool in the anaesthesiologists armamentarium as a safe alternative to general anaesthesia for upper limb surgery, providing complete muscle relaxation, stable intraoperative haemodynamic and smooth transition to postoperative pain relief1 reducing the need for opioid analgesics. But it has been observed that the brachial plexus block alone doesn’t prevent the tourniquet pain entirely because of varied mechanisms. The primary aim of this study was to determine whether a subcutaneous ring of local anaesthetic (0.5% ropivacaine) on the inner aspect of the upper arm just distal to axillary crease will significantly decrease tourniquet pain. Approach of hypothesis: In this study 100 patients with comparable demographics in Group A (ASA I and II) underwent USG guided subcutaneous axillary ring injection with 15 ml of local anaesthetic 0.5% ropivacaine for supraclavicular block and 5 ml of 0.5% ropivacainefor axillary ring block. Group B (ASA I and II) also included 100 patients who received only USG guided supraclavicular block using 15 ml of 0.5% ropivacaine prior to inflation of an upper arm tourniquet. Result: It was observed that Group A who receivedboth supraclavicular block and axillary ring block tolerated the upper arm tourniquet for a longer period than those who received only supraclavicular block (mean of 36.9 min vs. 6.9 min) (p = 0.014) respectively. Conclusion: We demonstrated that axillary ring block will decrease tourniquet pain which leads to discomfort is a common obstacle in anaesthetic management and increase tourniquet tolerance period even with excellent regional anaesthesia of the upper extremity.


 

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Rayees Najib, Umer Iqbal Peer, Ruksana Najeeb. Effectiveness of Usg Guided Axillary Ring Block in Reducing Tourniquet Pain in Patients Undergoing Upper Extremity Surgery With Supraclavicular Brachial Plexus Block. Indian J Anesth Analg. 2020;7(5):
1125–1130
 

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Received Accepted Published
N/A N/A N/A
DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.7520.37

Keywords

Axillary ring block; Brachial plexus block; Tourniquet pain; Visual analogue scale

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